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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 7/26/2016 <br />Submitted on: 7/21/2016 2:04:12PM <br />CERS ID: 10185563 <br />Submitted by: Vanessa Barajas Email: vanessa@dannysfalldecor.com Facility ID in CERS: <br />FA0016883 <br />Information prior to CIW processing <br />Information after CIW processing <br />CERS <br />OWNER INFORMATION (current EC database) <br />(current submittal) <br />field <br />Number of Facilities for this Owner : 1 <br />Owner ID OW0013724 <br />Owner name DAN R COSTA INC <br />Daniel R Costa <br />111 <br />Mailing address 1269 Spring Creek Dr <br />1269 Spring Creek Dr <br />113 <br />Ripon, CA 95366 <br />Ripon, CA 95366 <br />114, 115, 116 <br />Work phone 209-234-2004 <br />209-234-2004 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID FA0016883 <br />Facility name DAN R COSTA INC (WS) <br />DAN R COSTA INC (WS) <br />3 <br />Site address 17239 E LOUISE AVE <br />17239 E LOUISE AVE <br />103 <br />City ESCALON <br />ESCALON <br />104 <br />ZIP code 95320 <br />95320 <br />105 <br />Facility phone 209-234-2004 <br />209-234-2004 <br />102 <br />Facility mailing address 1269 Spring Creek Dr <br />1269 Spring Creek Dr. <br />108a <br />Ripon, CA 95366 <br />Ripon, CA 95366 <br />108b, 108c, 1084 <br />BILLING INFORMATION <br />Contact name Leanne Zerr <br />Diana Zazueta <br />140 <br />Address 1269 Spring Creek Dr <br />1269 Spring Creek Dr <br />143 <br />Ripon, CA 95366 <br />Ripon, CA 95366 <br />144, 145, 146 <br />Contact phone 209-234-2004 <br />209-234-2004 <br />141 <br />Contact email Leanne@dannysfaI[decor.com <br />ap@dannysfalldecor.com <br />142 <br />Mail invoices to Owner <br />Program record [ ] HMBP (] SQG HW [ ] LQG HW <br />[ ] RCRA HW New PR#: <br />created [ ] Tiered permit [ ] APSA [ ] CalARP <br />[ ] UST New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this c ndar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: <br />Date: -71Zv/( V <br />Accounting: Reviewed by: Date: -712,41111, <br />Clerical: [ ] File [ ] Relabel file [ ] Create <br />new file <br />[ ] Acct billed [ ] Surcharge verified <br />By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO <br />PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name Status Reactivated <br />Inactivated <br />1958 - HM -Farm Operations PR0525068 MUNIAPPA NAIDU Active [ ] <br />[ ] <br />2220 - SM HW GEN <5 TONS/YR PR0530541 ELENA MANZO Active [ ] <br />[ ] <br />2830 - AST FAC - SPCC EXEMPT PR0530540 ELENA MANZO Inactive [ ] <br />[ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0531585 not assigned Inactive [ ] <br />[ ] <br />