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SAN JOAQUIR-COUNTY ENVIRONMENTAL HEALTHVtPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 7/15/2014 <br /> Submitted on: 2/3/2014 10:10:01AM CERS ID: 10406626 <br /> Submitted by: Patricia Jones Email: patty.jones@americantower.com Facility ID in CERS: FA0022140 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0009900 <br /> Owner name American Tower American Tower 111 <br /> Mailing address PO Box 63604 PO Box 63604 113 <br /> Phoenix, AZ 85082 Phoenix, AZ 85082 114, 115, 116 <br /> Work phone 602-284-0280 602-284-0280 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0022140 <br /> Facility name American Tower- Peters CA, Site#40907 American Tower- Peters CA, Site#40907 3 <br /> Site address 791 Drais Rd 791 Drais Rd 103 <br /> City Stockton Stockton 104 <br /> Zip code 95215 95215 105 <br /> Facility phone 602-284-0280 602-284-0280 102 <br /> Facility mailing address PO Box 63604 PO Box 63604 108a <br /> Phoenix, AZ 85082 Phoenix, AZ 85082 108b,logic,load <br /> BILLING INFORMATION <br /> Contact name American Tower American Tower 140 <br /> Address PO Box 63604 PO Box 63604 143 <br /> Phoenix, AZ 985082 Phoenix, AZ 985082 144, 145, 146 <br /> Contact phone 602-284-0280 602-284-0280 141 <br /> Contact email scot.sandefur@americantower.com scot.sandefur@americantower.com 142 <br /> Mail invoices to Facility <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW 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: "r— <br /> Date: <br /> i <br /> Accounting: Reviewed by: (b Date: 4/1-1211,LClerical: [ ] File [ ] Relabe�lfile [ ] 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 Ina i ed <br /> 1926-HMBP-Unstaffed Network Location PRO538296 JAMIE DE LA ROSA Active [ <br />