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SAN JOAQUIN %,vUNTY ENVIRONMENTAL HEALTH DCPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 7/25/2014 <br />Submitted on: 3/13/2014 12:03:41 PM CERS ID: 10138537 <br />Submitted by: Daniel Perez Email: daniel.perez@simplot.com Facility ID in CERS: FA0009351 <br />Information prior to CIW processing <br />OWNER INFORMATION (current EC database) <br />Owner ID OW0007351 <br />Owner name J R Simplot <br />Mailing address P.O. Box 70013 <br />Boise, ID 83707-0113 <br />Work phone 208-672-2700 <br />FACILITY FILE INFORMATION <br />Facility ID <br />Facility name <br />Site address <br />City <br />Zip code <br />Facility phone <br />Facility mailing address <br />BILLING INFORMATION <br />Contact name <br />Address <br />Contact phone <br />Contact email <br />Mail invoices to <br />FA0009351 <br />SIMPLOT GROWERS SOLUTIO <br />2851 W Harney Ln <br />Lodi <br />95242 <br />559-439-3900 <br />2851 W Harney Ln <br />Lodi, CA 95242 <br />SIMPLOT GROWERS SOLUTIONS <br />2851 W Harney Ln <br />Lodi, CA 95242 <br />Not Specified <br />steve.woods@simplot.com <br />Facility <br />Information after CIW processing CERS <br />(current submittal) field <br />J R Simplot 111 <br />P.O. Box 70013 113 <br />Boise, ID 83707-0113 114, 115, 116 <br />208-672-2700 112 <br />SGS Lodi <br />3 <br />2851 W Harney Ln <br />103 <br />Lodi <br />104 <br />95242 <br />105 <br />559-439-3900 <br />102 <br />2851 W Harney Ln <br />108a <br />Lodi, CA 95242 <br />108b, 108c, 108d <br />Steve Woods -- <br />140 <br />2851 Harney Lane <br />143 <br />Lodi, Ca 95242 <br />144, 145, 146 <br />209-369-1921 <br />141 <br />steve.woods@simplot.com <br />142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />New PR#: <br />New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this year [ ] <br />next calendar year [ ] exempt from billing <br />calendar <br />Processed through CERS Integration Wizard by: \ AA <br />Date: 'I <br />- P� 't <br />— <br />Accounting: Reviewed by: Date: 19% --- <br />Clerical: <br />— ----,----- <br />[/j File .,<]' Relabel file [ ] Create new file <br />r <br />[ l_ c billed [ ] Surcharge verified <br />-------------------------------- <br />� <br />By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID <br />Employee name <br />Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location PR0519570 <br />JAMIE DE LA ROSA <br />Active [ ] [ ] <br />1962 - CaIARP PROGRAM 2 FACILITY PRO514569 <br />RAYMOND VON FLUE Active [ ] [ ] <br />1995 - CaIARP FAC STATE SURCHARGE FEE PR0518996 <br />HAZ MAT SJC OES <br />Active [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR PR0513783 <br />ARIS VELOSO <br />Active [ ] [ ] <br />2246 - PACT TRANSFER RECORD - OES RMP PR0527099 <br />HAZ MAT SJC OES <br />Inactive [ ] [ ] <br />2381 - UST FACILITY (BEFORE 1/84) - obsolete PR0503187 <br />MICHAEL KITH <br />Inactive [ ] [ ] <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0509351 <br />HAZ MAT SJC OES <br />Inactive [ ] [ ] <br />2831 -AST FAC >/= 1,320 - <10 K GAL CUMULATIVE PR0536085 <br />ARIS VELOSO <br />Active, Exempt [ ] [ ] <br />4740 - WASTE TIRE SITE - EXEMPT PR0535411 <br />HARPRIT MATTU <br />Active [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0532661 <br />not assigned <br />Inactive [ ] [ ] <br />