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SAN JOAQUlr.-,i OUNTY ENVIRONMENTAL HEALTh-oEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 3/1912015 <br /> Submitted on: 1127/2015 2:48:55PM CERS ID: 10181767 <br /> Submitted by: Joseph Ghia Email: jg1955@ve[ociter.net Facility ID in CERS: FA0005211 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0004078 <br /> Owner name GHIO FAMILY TRUST GHIO FAMILY TRUST 111 <br /> Mailing address 11136 E FAIRCHILD RD 11136 E FAIRCHILD RD 113 <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 114. 115, 116 <br /> Work phone (209) 931-2509 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0005211 <br /> Facility name GHIO FARMS GHIO FARMS 3 <br /> Site address 11136 E FAIRCHILD RD 11136 E FAIRCHILD RD 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95215 95215 105 <br /> Facility phone 209-931-2509 (209) 931-2509 0 102 <br /> Facility mailing address 11136 E FAIRCHILD RD 11136 E FAIRCHILD RD 108a <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 1084, 108c, 108d <br /> BILLING INFORMATION <br /> Contact name GHIO FARMS GHIO FARMS 140 <br /> Address 11136 E FAIRCHILD RD 11136 E FAIRCHILD RD 143 <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 144. 145: 146 <br /> Contact phone Not Specified (209) 931-2509 141 <br /> Contact email 142 <br /> Mail invoices to Owner <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ J next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: 6�" Date: -11 - 15 <br /> Accounting: Reviewed by: � Dater!�3)/S r Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ J Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1958-HM-Farm Operations doodab PR0525853 HAZA SAEED Active [ ] [ ] <br /> 2333-FARM UST 41 FACILITY-obsolete PRO501754 STEVE SASSON Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0533360 not assigned Inactive [ ] [ ] <br />