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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 6/29/2014 <br />Submitted on: 2/20/2014 7:33:15PM <br />Submitted by: Daryll Quaresma Email: daryllpq@gmail.com <br />CERS ID: 10185331 <br />Facility ID in CERS: FA0016741 <br />Processed through CERS Integration Wizard by: I_ Date: <br />Information prior to CIW processing <br />Information after CIW processing <br />CERS <br />[ ] Acct billed [ ] Surcharge verified <br />--------------------------------------------------- <br />(current EC database) <br />(current submittal) <br />field <br />OWNER INFORMATION <br />1958 - HM -Farm Operations PR0524926 not assigned <br />Active [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR PR0530684 ELENA MANZO <br />Owner ID <br />OW0013582 <br />Active, Exempt [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0532177 not assigned <br />Owner name <br />2 Q FARMING <br />2 Q FARMING <br />Mailing address <br />26301 S UNION RD <br />1845 Riverview Circle <br />113 <br />MANTECA, CA 95337 <br />Ripon, CA 95366 <br />114, 115, 116 <br />Work phone <br />209-599-8301 / <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0016741 <br />Facility name <br />2 Q FARMING <br />2 Q FARMING <br />3 <br />Site address <br />22101 S MANTECA RD <br />22101 S MANTECA RD <br />103 <br />City <br />MANTECA <br />MANTECA <br />104 <br />Zip code <br />95337 <br />95337 <br />105 <br />Facility phone <br />209-823-4886 <br />209-599-8301 1 <br />102 <br />Facility mailing address <br />26301 S UNION RD <br />1845 RIVERVIEW CIRCLE <br />108a <br />MANTECA, CA 95337 <br />RIPON, CA 95366 j <br />108b, 108c, 108d <br />BILLING INFORMATION <br />- <br />Contact name <br />2 Q FARMING <br />2 Q FARMING <br />140 <br />Address <br />26301 S UNION RD <br />1845 Riverview Circle <br />143 <br />MANTECA, CA 95337 <br />Ripon, CA 95366 <br />144, 145, 146 <br />Contact phone <br />Not Specified <br />209-599-8301 <br />141 <br />Contact email <br />142 <br />Mail invoices to <br />Owner <br />Program record [ ] <br />HMBP [ ] SQG HW [ ] LQG HW <br />[ ] RCRA HW New PR#: <br />created [ ] Tiered permit [ ] APSA [ ] CalARP <br />[ ] UST New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate this calendar year [ <br />] next [ ] exempt from billing <br />Processed through CERS Integration Wizard by: I_ Date: <br />tccalendar lyear <br />--------------------------------------------------- <br />Accounting: Reviewed by: LP? Date: 7 3 1 ` f Clerical: <br />'K File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified <br />--------------------------------------------------- <br />By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING <br />THROUGH CIW <br />Program Element and Description Record ID Employee name Status Reactivated Inactivated <br />1958 - HM -Farm Operations PR0524926 not assigned <br />Active [ ] [ ] <br />2220 - SM HW GEN <5 TONS/YR PR0530684 ELENA MANZO <br />Active [ ] [ ] <br />2830 - AST FAC - SPCC EXEMPT PR0530683 ELENA MANZO <br />Active, Exempt [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0532177 not assigned <br />Inactive <br />