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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 7:28:04AM CERS ID: 10406635 <br />Submitted by: Jennifer Ruth Email: jennifer.ruth@americantower.com Facility ID in CERS: FA0022488 <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 />OW0019989 <br />American Tower <br />PO Box 63604 <br />Phoenix, AZ 85082 <br />602-284-0280 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0022488 <br />Facility name <br />American Tower - Weberstown Rebuild CA, <br />Site address <br />4010 Claremont Ave <br />City <br />Stockton <br />ZIP code <br />95207 <br />Facility phone <br />602-284-0280 <br />Facility mailing address <br />PO Box 63604 <br />Phoenix, AZ 85082 <br />BILLING INFORMATION <br />Contact name <br />American Tower 265280 <br />Address <br />PO Box 63604 <br />Phoenix, AZ 85082 <br />Contact phone <br />602-284-0280 <br />Contact email <br />scot.sandefur@americantower.com <br />Mail invoices to <br />Account <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 />American Tower - Weberstown Rebuild CA, 3 <br />4010 Claremont Ave 103 <br />Stockton 104 <br />95207 105 <br />602-284-0280 102 <br />10 Presidential Way <br />Woburn, MA 01801 <br />108a <br />108b, 108c, 108d <br />American Towers - EH&S - SITE #265280 140 <br />10 Presidential Way 143 <br />Woburn, MA 01801 144, 145, 146 <br />602-284-0280 141 <br />scot.sandefur@americantower.com 142 <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 U4, Date: <br />year [ ] next calendar year [ ] exempt from billing <br />+ <br />Processed through CERS Integration Wizard by: � 4,Date: ' a-cl - <br />Accounting: Reviewed by tb Date: gl3pllS Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />r�_�Iled-tea verified erified 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 PRO539336 HAZA SAEED Active, Exempt I I I I <br />