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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: <br /> Submitted on: 6/19/2015 12:15:52PM 6/24/2015 <br /> CERS ID: 10614328 <br /> Submitted by: Jose Valdez Email:jose.valdez6600@broncowine.com <br /> Facility ID in CERS: incorrect <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0020812 <br /> Owner name West coast grape farming WEST COAST GRAPE FARMING INC 111 <br /> Mailing address 6342 Bystrum road P.O. BOX 488 <br /> Ceres, CA 95307 CERES, CA 95307 11a, 11e11s <br /> Work phone 209-272-3000 209-272-3000 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0022853 <br /> Facility name Shady Oaks Ranch Shady Oaks Ranch 3 <br /> Site address 15800 N THORNTON RD 15800 N Thornton Rd 103 <br /> City lodi lodi 104 <br /> ZIP code 95242 95242 105 <br /> Facility phone 209-272-3000 209-272-3000 <br /> 102 <br /> Facility mailing address 6342 bystrum road P.O. BOX 488 108a <br /> Ceres, CA 95307 CERES, CA 95307 108b,108c,1084 <br /> BILLING INFORMATION <br /> Contact name Frank Canela FRANK CANELA 140 <br /> Address 6342 Bystrum Road P.O. BOX 488 143 <br /> Ceres, CA 95307 CERES, CA 95307 144, 145, 146 <br /> Contact phone 209-272-3035 209-272-3035 141 <br /> Contact email frank.canela@broncowine.com frank.canela@broncowine.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ SQG HW [ ] LQG HW [ ] RCRA HW New PR#:P OSI.002, ti cSk c7 i <br /> created [ ] Tiered permit APSA CalARP .1 <br /> [ ] [ ] UST New PE: � <br /> Assigned to: Rr,s l e[cS a <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: %--A Date: 6 x,)\46" <br /> -- ----- ---- <br /> Accounting: Reviewed by: 11P2 _Date: -7LK � Clerical: File <br /> [ 1 [ 1 Relabel file [ ] Create new file <br /> [ Acct billed _ d y 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 PR0539978 JAMIE DE LA ROSA Active [ ] [ <br /> nr�C: <br /> A 3 l <br /> ��,�5 �a� � a83i Y,ased vn Cf2S skb„,I+� <br />