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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 12/1/2016 <br />Submitted on: 11/11/2016 8:15:07AM <br />Submitted by: Alex Munoz Email: alex.munoz@americantower.com <br />CERS ID: 10406635 <br />Facility ID in CERS: FA0022488 <br />Information prior to CIW processing <br />Information after CIW processing <br />CERS <br />OWNER INFORMATION <br />(current EC database) <br />(current submittal) <br />field <br />4010 Claremont Ave <br />Number of Facilities for this Owner: 1 <br />City <br />Stockton <br />Owner ID <br />OW0019989 <br />ZIP code <br />95207 <br />Owner name <br />AMERICAN TOWERS - EH&S Dept. <br />AMERICAN TOWERS - EH&S Dept. <br />111 <br />Mailing address <br />10 Presidential Way <br />10 Presidential Way <br />113 <br />10 Presidential Way <br />Woburn, MA 01801 <br />Woburn, MA 01801 <br />114, 115, 116 <br />Work phone <br />602-284-0280 <br />602-999-5139 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0022488 <br />Facility name <br />American Tower - Weberstown Rebuild CA, <br />American Tower - Weberstown Rebuild CA, Sit <br />3 <br />Site address <br />4010 Claremont Ave <br />4010 Claremont Ave <br />103 <br />City <br />Stockton <br />Stockton <br />104 <br />ZIP code <br />95207 <br />95207 <br />105 <br />Facility phone <br />602-284-0280 <br />602-999-5139 <br />102 <br />Facility mailing address <br />10 Presidential Way <br />10 Presidential Way <br />108a <br />Woburn, MA 01801 <br />Woburn, MA 01801 108b, 108c, 108d <br />BILLING INFORMATION <br />Contact name American Towers - EH&S - SITE #265280 - <br />Address 10 Presidential Way <br />Woburn, MA 01801 <br />Contact phone 602-284-0280 <br />Contact email scot.sandefur@americantower.com <br />Mail invoices to Account <br />American Towers - EH&S - SITE #265280 - Wi 140 <br />10 Presidential Way 143 <br />Woburn, MA 01801 144, 145, 146 <br />602-999-5139 141 <br />Charmayne.eriacho@americantower.com 142 <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST <br />Please bill: [ ] full calendar year [ ] prorate <br />`this calendar year <br />v <br />Processed through CERS Integration Wizard by: "' _,, Date <br />New PR#: <br />New PE: <br />Assigned to: <br />[ ] next calendar year [ ] exempt from billing <br />N2--1.1Vi <br />------------------------------------------------ <br />Accounting: Reviewed by: Date: 1214, /I !, Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status Reactivated Inactivated <br />xpt [ <br />X16 - HMBP-Remote Network Location/ chem units PR0539336 HAZA SAEED Active, E ] [ ] <br />