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F� SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConneet by CERS Integration Wizard <br /> Date run: 3126f2015 <br /> Submitted on: 2/1812015 4:25:27RM CERS ID: 10986509 <br /> Submitted by: Diego Olagaray Email: diegoolagaray@yahoo.com Facility ID in CERS: FA0017481 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0014322 <br /> Owner name OLAGARAY BROTHERS OLAGARAY BROTHERS 111 <br /> Mailing address 2375 W ARMSTRONG RD 2375 W ARMSTRONG RD 113 <br /> LOD], CA 95242 LODI, CA 95242 114, 115, 116 <br /> Work phone 209-339-8374 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017481 <br /> Facility name OLAGARAY BROTHERS OLAGARAY BROTHERS 3 <br /> Site address 11510 W STATE RT 12 11510 W STATE RT 12 103 <br /> City LODI LODI 104 <br /> ZIP code 95242 95242 105 <br /> Facility phone 209-339-8374 (209) 339-8374 0 102 <br /> Facility mailing address 2375 W ARMSTRONG RD 2375 W ARMSTRONG RD 108a <br /> LODI, CA 95242 LODI, CA 95242 108x,108c,108d <br /> BILLING INFORMATION <br /> Contact name OLAGARAY BROTHERS OLAGARAY BROTHERS 140 <br /> Address 2375W ARMSTRONG RD 2375 W ARMSTRONG RD 143 <br /> LODI, CA 95242 LODI, CA 95242 144, 145, 146 <br /> Contact phone Not Specified 209-339-8374 141 <br /> Contact email 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: yv� Date: <br /> Accounting: Reviewed by: Date: 3)2,0)1 S 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 PR0525666 JAMIE DE LA ROSA Active [ ] [ ] <br /> 2830-AST FAC -SPCC EXEMPT PRO530522 ARIS VELOSO Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PR0534755 not assigned Inactive [ ] [ ] <br />