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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 1/6/2017 <br />Submitted on: 1/3/2017 10:44:34PM CERS ID: 10145347 <br />Submitted by: Debra Voth Email: Debra.Voth@verizonwireless.com Facility ID in CERS: FA0022083 <br />OWNER INFORMATION <br />Owner I D <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />Number of Facilities for this Owner: 89 <br />OW0008734 <br />Verizon Wireless <br />295 Parkshore Drive <br />Folsom, CA 95630 <br />866-694-2415 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0022083 <br />Facility name <br />Verizon Wireless Spanos Park <br />Site address <br />5023 W EIGHT MILE RD <br />City <br />Stockton <br />ZIP code <br />95209 <br />Facility phone <br />866-694-2415 <br />Facility mailing address 295 Parkshore Drive <br />Folsom, CA 95630 <br />BILLING INFORMATION <br />Contact name Environmental Compliance <br />Address 295 Parkshore Drive <br />Folsom, CA 95630 <br />Contact phone 866-694-2415 <br />Contact email Armand. Delgado@VerizonWireless. Com <br />Mail invoices to Account <br />Information after CIW processing CERS <br />(current submittal) field <br />Verizon Wireless <br />111 <br />295 Parkshore Drive <br />113 <br />Folsom, CA 95630 <br />114, 115, 116 <br />8666942415 <br />112 <br />Verizon Wireless Spanos Park 3 <br />5023 W Eight Mile Rd 103 <br />Stockton 104 <br />95209 105 <br />8666942415 102 <br />295 Parkshore Drive 108a <br />Folsom, CA 95630 108b, 108c, 108d <br />Environmental Compliance 140 <br />295 Parkshore Drive 143 <br />Folsom, CA 95630 144, 145, 146 <br />8666942415 141 <br />Arm and. Delgado@VerizonWire less. Com 142 <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: k -,W Date: �' t <br />Accounting: Reviewed by: LO Date: I I9 1 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 />/10-HMBP-Common Materials/hem units PR0538211 HAZA SAEED Active [ ] [ ] <br />1' 11-1 2 <br />