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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: <br />1/10/2017 <br />Submitted on: 1/3/2017 11:16:47PM <br />CERS ID: 10640173 <br />Submitted by: Debra Voth <br />Email: Debra.Voth@verizonwireless.com <br />Facility ID in CERS: <br />incorrect <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 />Number of Facilities for this Owner : 1 <br />Owner ID <br />OW0021259 <br />Owner name <br />Verizon Wireless <br />Verizon Wireless <br />111 <br />Mailing address <br />295 Parkshore Drive <br />295 Parkshore Drive <br />113 <br />Folsom, CA 95630 <br />Folsom, CA 95630 <br />114, 115, 116 <br />Work phone <br />866-694-2415 <br />(866) 694-2415 <br />112 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0023142 <br />Facility name <br />Verizon Wireless Weston Ranch <br />Verizon Wireless Weston Ranch <br />3 <br />Site address <br />1614 ISHI GOTO ST <br />1614 Ishi Goto St <br />103 <br />City <br />Stockton <br />Stockton <br />104 <br />ZIP code <br />95206 <br />95206 <br />105 <br />Facility phone <br />866-694-2415 <br />(866) 694-2415 <br />102 <br />Facility mailing address <br />295 Parkshore Drive <br />295 Parkshore Drive <br />108a <br />Folsom, CA 95630 <br />Folsom, CA 95630 <br />108b, 108c, 108d <br />BILLING INFORMATION <br />Contact name Environmental Compliance Environmental Compliance 140 <br />Address 295 Parkshore Drive 295 Parkshore Drive 143 <br />Folsom, CA 95630 Folsom, CA 95630 144, 145, 146 <br />Contact phone 866-694-2415 (866) 694-2415 141 <br />Contact email armand.delgado@vzw.com armand.delgado@vzw.com 142 <br />Mail invoices to Account <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 this calendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: V14\1 Date: \ ' \p , \ -] <br />------------------------------------------ <br />Accounting: Reviewed by: _16 Date: !�l o Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />------------------------- <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Record ID Employee name Status Reactivated Inactivated <br />1920 - HMBP-Common Materials 1 chem units PR0540480 HAZA SAEED Active [ ] [ ] <br />