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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 1/15/2016 <br />Submitted on: 1/12/2016 5:38:03PM <br />Submitted by: Sandy Kiefer Email: hspacking@aol.com <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />Number of Facilities for this Owner : 1 <br />OW0014410 <br />H S PACKING CO <br />PO BOX 415 <br />HOLT, CA 95234-0415 <br />209-463-2364 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0017569 <br />Facility name <br />H S PACKING CO <br />Site address <br />905 MCDONALD RD <br />City <br />STOCKTON <br />ZIP code <br />95206 <br />Facility phone <br />209-463-2364 <br />Facility mailing address <br />PO BOX 415 <br />HOLT, CA 95234-0415 <br />BILLING INFORMATION <br />Contact name <br />H S PACKING CO <br />Address <br />9050 MCDONALD RD <br />STOCKTON, CA 95206 <br />Contact phone <br />209-463-2364 <br />Contact email <br />Mail invoices to <br />Owner <br />CERS ID: 10186647 <br />Facility ID in CERS: FA0017569 <br />Information after CIW processing CERS <br />(current submittal) field <br />Herb Speckman Farms 111 <br />PO Box 415 113 <br />Holt, CA 95234-0415 114, 115, 116 <br />209-649-3456 112 <br />HERB SPECKMAN FARMS PARTNERSHII 3 <br />9050 MCDONALD RD 103 <br />STOCKTON 104 <br />95206 105 <br />209-649-3456 102 <br />PO Box 415 <br />Holt, CA 95234-0415 <br />108a <br />108b, 108c, 108d <br />Herb Speckman Farms Partnership - Rob 140 <br />PO Box 415 143 <br />Holt, CA 95234-0415 144, 145, 146 <br />209-649-3456 141 <br />hspacking@aol.com 142 <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 thisw ,clendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: 'W Date: ' ► '� <br />Accounting: Reviewed by: Date: Clerical: [ ] 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 />)n958 - HM -Farm Operations PR0525821 MUNIAPPA NAIDU Active [ ] [ ] <br />2221 - USED OIL ONLY - <5 TONS[YR PR0538613 FATINAH ZAREEF Active [ ] [ ] <br />2830 - AST FAC - SPCC EXEMPT PR0530603 FAT]NAH ZAREEF Active [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PRO531546 not assigned Inactive [ ] [ ] <br />