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SAN JOAQUi OUNTY ENVIRONMENTAL HEALTHMPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/11/2015 <br /> Submitted on: 6/5/2015 4:22:53PM CERS ID: 10415701 <br /> Submitted by: Julie Anenson Email:julie.anenson@cbi.com Facility]Din CERS: FA0022504 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0020014 <br /> Owner name New Cingular Wireless PCS, LLC dba AT&T New Cingular Wireless PCS, LLC dbaAT&T 111 <br /> Mailing address PO BOX 5095, RM 4W200 308 S. Akard St., Room 1708 113 <br /> SAN RAMON, CA 94583 Dallas, TX 75202 114, 115, 116 <br /> Work phone 925-823-8954 214-464-2626 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0022504 <br /> Facility name AT&T Mobility- BEN HOLT(35516) AT&T Mobility- BEN HOLT(35516) 3 <br /> Site address 6844 Alexandria PI 6844 Alexandria PI 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95207 95207 105 <br /> Facility phone 800-638-2822 8006382822 102 <br /> Facility mailing address PO BOX 5095, RM 4W200 308 S. Akard St., Room 1708 108a <br /> SAN RAMON, CA 94583 Dallas, TX 75202 10eb,108c,toed <br /> BILLING INFORMATION <br /> Contact name Manager EH&S EPCRA AT&T Mobility Manager EH&S EPCRA 140 <br /> Address PO BOX 5095, RM 4W200 5001 Executive Pkwy, RM 4W2001 143 <br /> SAN RAMON, CA 94583 San Ramon, CA 94583 144, 145, 146 <br /> Contact phone 925-823-8954 214464-2626 141 <br /> Contact email g43573@att.com g43573@att.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LOG HW [ ] RCRAHW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] 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: 912-0 Date: 6/(t k <br /> --------------------------------------------- <br /> Accounting: Reviewed by: 1P Date: W17-11 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 /> 1926-HMBP-Unstaffed Network Location PRO539358 HAZA SAEED Active, Exempt I ] I I <br />