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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 219/2015 <br /> Submitted Qn: 1/13/2015 9:17:01 PM CERS ID: 10182049 <br /> Submitted by:john veenstra Email: veenstrafarming@gmail.com Facility ID in CERS: FA0006228 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0004963 <br /> Owner name VEENSTRA FARMING Joann Veenstra 111 <br /> Mailing address 15863 SEXTON RD 15863 SEXTON RD 113 <br /> ESCALON, CA 95320 ESCALON, CA 95320 114, 115,116 <br /> Work phone 209-838-2894 (209) 838-2894 112 <br /> FACILITY DILE INFORMATION <br /> Facility ID FA0006228 <br /> Facility name VEENSTRA FARMING VEENSTRA FARMING 3 <br /> Site address 15863 S SEXTON RD 15863 S SEXTON RD 103 <br /> City ESCALON ESCALON 104 <br /> ZIP code 95320 95320 105 <br /> Facility phone 209-838-2894 (209) 838-2894 102 <br /> Facility mailing address 15863 SEXTON RD 15863 SEXTON RD 108a <br /> ESCALON, CA 95320 ESCALON, CA 95320 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name VEENSTRA FARMING VEENSTRA FARMING 140 <br /> Address 15863 SEXTON RD ,/� 15863 SEXTON RD 143 <br /> ESCALON, CA 95320 ESCALON, CA 95320 144, 145, 146 <br /> Contact phone 209-838-2894 (209) 838-2894 141 <br /> Contact email142 <br /> Mail invoices to "rte <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] 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: �vy"� Date: <br /> Accounting: Reviewed by: Date: l 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 /> 1958-HM-Farm Operations PRO525906 MICHAEL PARISSI Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PR0538996 ELENA MANZO Active [ ] [ <br /> 2221 -USED OIL ONLY-<5 TONS/YR PR0538467 ELENA MANZO Active, Exempt [ ] [ <br /> 2333-FARM UST#1 FACILITY-obsolete PR0504513 ALISON YOUNGBLOOD Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0532355 not assigned Inactive [ ] [ ] <br />