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SAN JOAQU1`1rCOUNTY ENVIRONMENTAL HEALTHT>15PARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6J2912014 <br /> Submitted on: 2/20/2014 7:33:15PM CERS ID: 10185331 <br /> Submitted by: Daryll Quaresma Email: daryllpq@gmail.com Facility ID in CERS: FA0016741 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0013582 <br /> Owner name 2 Q FARMING 2 Q FARMING 111 <br /> Mailing address 26301 S UNION RD 1845 Riverview Circle 113 <br /> MANTECA, CA 95337 Ripon, CA 95366 114, 115, 116 <br /> Work phone 209-599-8301 �- 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0016741 <br /> Facility name 2 Q FARMING 2 Q FARMING 3 <br /> Site address 22101 S MANTECA RD 22101 S MANTECA RD 1Q3 <br /> City MANTECA MANTECA 104 <br /> Zip code 95337 95337 105 <br /> Facility,phone 209-823-4886 209-599-8301 102 <br /> Facility mailing address 26301 S UNION RD 1845 RIVERVIEW CIRCLE 108a <br /> MANTECA, CA 95337 RIPON, CA 95366 108b„108c,108d <br /> BILLING INFORMATION <br /> Contact name 2 Q FARMING 2 Q FARMING 140 <br /> Address 26301 S UNION RD 1845 Riverview Circ 143 <br /> MANTECA, CA 95337 Ripon, CA 95366 144, 145, 146 <br /> Contact phone Not Specified 209-599-8301 141 <br /> Contact email / 142 <br /> Mail invoices to Owner f J <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 [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date: (0 <br /> Accounting: Reviewed by: CJ�5 Date: _71-3h Clerical: `D6 File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] 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 PR0524926 not assigned Active [ ] [ <br /> 2220-SM HW GEN<5 TONS/YR PRO530684 ELENA MANZO Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PR0530683 ELENA MANZO Active, Exempt [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0532177 not assigned Inactive [ ] [ ] <br />