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SAN JOAQUIIri COUNTY ENVIRONMENTAL HEALTHbEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 7/25/2014 <br /> Submitted on: 3/4/2013 3:31:23PM CERS ID: 10416031 <br /> Submitted by: George Vierra Email: gardngirl60@aol.com Facility ID in CERS: FA0002804 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0002226 <br /> Owner name VIERRA, ANNA M &SONS GEORGE VIERRA 111 <br /> Mailing address PO BOX 6900 PO BOX 317 113 <br /> STOCKTON, CA 95206 HOLT, CA 95234 114, 115, 116 <br /> Work phone 209-463-7081 209 4824293 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0002804 <br /> Facility name VIERRA, ANNA M & SONS 39-53 GV Farms 3 <br /> Site address 8181 W HWY 4 8181 W Highway 4 103 <br /> City STOCKTON Stockton 104 <br /> Zip code 95206 95206 105 <br /> Facility phone 209-547-0586 209 4824293 102 <br /> Facility mailing address PO BOX 6900 PO BOX 317 108a <br /> STOCKTON, CA 95206 HOLT, CA 95234 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name VIERRA, ANNA M &SONS 39-53 GEORGE VIERRA 140 <br /> Address PO BOX 6900 PO BOX 317 143 <br /> STOCKTON, CA 95206 HOLT, CA 95234 144, 145, 146 <br /> Contact phone Not Specified 209 4824293 141 <br /> Contact email georgevierra@aol.com 142 <br /> Mail invoices to Facility <br /> Program record WMBP �pSQG HW [ ] LOG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [/] APSA [ ] CaIARP [ ] UST New PE: Z <br /> Assigned to: <br /> Please bill: full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: _, -- r <br /> Date: ) (Z`z((`l <br /> Accounting: Reviewed by: — Date: Rlgv# Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> Acct billed F ] Surrnarge yeAfied `���� B Date: <br /> �1V ------------------------------- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 2765-EMPLOYEE HOUSING-PERMANENT>180 DAYS PR0270053 OMRAN SOOD Inactive [ ] [ ] <br /> 91x-70 <br />