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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 1/4/2017 <br />Submitted on: 1/3/2017 8:54:29PM <br />Submitted by: Debra Voth Email: Debra.Voth@verizonwireless.com <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 />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 />FA0010774 <br />Facility name <br />Verizon Wireless Bellota <br />Site address <br />7860 Gilmore Rd <br />City <br />Linden <br />ZIP code <br />95236 <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 />CERS ID: 10142479 <br />Facility ID in CERS: FA0010774 <br />Information after CIW processing <br />CERS <br />(current submittal) <br />field <br />vPrYI Lur v� I' rPr s s <br />fnvh-cm a <br />111 <br />295 Parkshore Drive <br />113 <br />Folsom, CA 95630 <br />114, 115, 116 <br />(866) 694-2415 <br />112 <br />Verizon Wireless Bellota 3 <br />7860 Gilmore Rd 103 <br />Linden 104 <br />95236 105 <br />(866) 694-2415 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 />(866) 694-2415 141 <br />Armand.Delgado@VerizonWireless.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: ArIV6( M Date: i /AI /1-1 <br />--- — ----- --- <br />Accounting: Reviewed by: Date: 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 />1921 - HMBP-Regular-Primary Location 0 chem units PR0513062 HAZA SAEED Active [ ] [ ] <br />2399 - UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510774 HAZ MAT SJC OES Inactive [ ] [ ] <br />