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SAN JOAQUIRCOUNTY ENVIRONMENTAL HEALTRVEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 3/26/2015 <br /> Submitted on: 1/30/2015 8:37:35AM CERS ID: 10186451 <br /> Submitted by: FREDERICK FERRERO Email: ferrero5@hotmail.com Facility ID in CERS: FA0017437 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000486 <br /> Owner name FERRERO, FREDERICK D FREDERICK D FERRERO 111 <br /> Mailing address 4353 W WOODBRIDGE RD 4353 W WOODBRIDGE RD 113 <br /> LODI, CA 95242 LODI, CA 95242 114, 115,116 <br /> Work phone 209-369-9652 209 369 9652 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017437 <br /> Facility name FREDERICK D FERRERO FREDERICK D FERRERO HOME 3 <br /> Site address 4353 W WOODBRIDGE RD 4353 W WOODBRIDGE RD 103 <br /> City LODI LODI 104 <br /> ZIP code 95242 95242 105 <br /> Facility phone 209-369-9652 209 369 9652 102 <br /> Facility mailing address 4353 W WOODBRIDGE RD 4353 W WOODBRIDGE RD 108a <br /> LODI, CA 95242 LODI, CA 95242 108b,108c,load <br /> BILLING INFORMATION <br /> Contact name FREDERICK D FERRERO FREDERICK D FERRERO 140 <br /> Address 4353 W WOODBRIDGE RD 4353 W WOODBRIDGE RD 143 <br /> LODI, CA 95242 LODI, CA 95242 144, 145, 146 <br /> Contact phone 209-369-9652 209 369 9652 141 <br /> Contact email ferrero5@hotmail.com 142 <br /> Mail invoices to Owner <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: 00-1 Date: <br /> ------ --------- ----- ---- ----- - - - - --- <br /> Accounting: Reviewed by: L,10.) Date: ZUII Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ---------------------------------------------- <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 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2221 -USED OIL ONLY-<5 TONS/YR PR0561 ARIS VELOSO Inactive [ ] [ ] <br /> 2840-AST EXEMPT FAC <1,320 GAL PR0529635 WILLY NG Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0532451 not assigned Inactive [ ] [ ] <br />