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SAN JOAQUIN--BOUNTY ENVIRONMENTAL HEALTAM&EPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 7/9/2014 <br /> Submitted on: 2/27/2014 6:17:47PM CERS ID: 10415395 <br /> Submitted by: Sheila Caballero Email: sheila.caballero@shawgrp.com Facility ID in CERS: <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008527 <br /> Owner name New Cingular Wireless PCS, LLC dba AT&T New Cingular Wireless PCS, LLC dba-Af*+ 111 <br /> Mailing address PO BOX 5095, ROOM 3E000 PO BOX 5095, ROOM 3E000 113 <br /> SAN RAMON, CA 94583 SAN RAMON, CA 94583 114, 115, 116 <br /> Work phone 925-823-8954 9258238954 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010743 <br /> Facility name AT&T WIRELESS SVCS AT&T Mobility-COLLIERVILLE (9863) 3 <br /> Site address 5019 E JAHANT RD 5019 E Jahant Rd 103 <br /> City COLLIERVILLE ACAMPO 104 <br /> Zip code 95220 95220 105 <br /> Facility phone 916-843-8100 8006382822 102 <br /> Facility mailing address 10030 GOETHE RD PO BOX 5095, ROOM 3E000 108a <br /> SACRAMENTO, CA 95827 SAN RAMON, CA 94583 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name AT&T WIRELESS SVCS Claudette Altamirano 140 <br /> Address 10030 GOETHE RD PO BOX 5095, ROOM 3E000 143 <br /> SACRAMENTO, CA 95827 SAN RAMON, CA 94583 144, 145, 146 <br /> Contact phone Not Specified 9258238954 141 <br /> Contact email CA696D@ATT.COM 142 <br /> Mail invoices to Account <br /> Program record HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: Ila <br /> Assigned to: 6ZF!9�C - <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ ) next calendar year [exempt from billing's <br /> Processed through CERS Integration Wizard by: Date: IJ I _ <br /> Accounting: Reviewed by: Date: _9 Clerical:—[ ] File [ ] Relabel file [ ] Create new file <br /> 4 j Real billed- [ }-Sureherge ver+#i By: Date: <br /> ------------------------------- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO510743 HAZ MAT SJC OES Inactive I I [ I <br /> JJ <br /> 2� <br />