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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 9/29/2015 <br />Submitted on: 9/25/2015 4:32:31AM <br />Submitted by: Jennifer Ruth Email: jennifer.ruth@americantower.com <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />OW0015416 <br />AMERICAN TOWERS <br />PO BOX 63604 <br />PHOENIX, AZ 85082 <br />602-284-0280 <br />yT01l11111III VA;114=11111I',N14010►5I_1 1101 <br />CERS ID: 10186963 <br />Facility ID in CERS: FA0018749 <br />Information after CIW processing CERS <br />(current submittal) field <br />AMERICAN TOWERS - EH&S Dept. 111 <br />10 Presidential Way 113 <br />Woburn, MA 01801 114, 115, 116 <br />602-284-0280 112 <br />Facility ID <br />FA0018749 <br />10 Presidential Way <br />108a <br />Facility name <br />AMERICAN TOWER CORP 15 FRENCH Ci <br />AMERICAN TOWER CORP 15 FRENCH Ci <br />3 <br />Site address <br />9156 S AIRPORT WAY <br />9156 S AIRPORT WAY <br />103 <br />City <br />STOCKTON <br />STOCKTON <br />104 <br />ZIP code <br />95206 <br />95206 <br />105 <br />Facility phone <br />602-284-0280 <br />(602) 284-0280 <br />102 <br />Facility mailing address <br />PO BOX 63604 <br />10 Presidential Way <br />108a <br />PHOENIX, AZ 85082 <br />Woburn, MA 01801 <br />108b, 10sc, toed <br />BILLING INFORMATION <br />Contact name <br />AMERICAN TOWERS 15/FRENCH 8302 <br />AMERICAN TOWERS - EH&S - SITE #830: <br />140 <br />Address <br />PO BOX 63604 <br />10 Presidential Way <br />143 <br />PHOENIX, AZ 85082-3604 <br />Woburn, MA 01801 <br />144, 145, 146 <br />Contact phone <br />602-284-0280 <br />602-284-0280 <br />141 <br />Contact email <br />scot, <br />scot.sandefur@americantower.com <br />142 <br />Mail invoices to <br />Oyer (�- <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 calendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: V Date: <br />-------------------------------------------------- <br />Accounting: Reviewed by. Lr� Date: l IS 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 />1921 - HMBP-Regular-Primary Location PR0527665 JAMIE DE LA ROSA Active [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0533320 not assigned Inactive [ ] [ ] <br />