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SAN JOAQUIrw-COUNTY ENVIRONMENTAL HEALTH86EPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 3/27/2015 <br /> Submitted on: 2/4/2015 1:57:44PM CERS ID: 10186681 <br /> Submitted by: Ghia Jones Email: ghia.jones@t-mobile.com Facility ID in CERS: FA0017758 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0014585 <br /> Owner name T-MOBILE USA INC T-MOBILE USA INC 111 <br /> Mailing address 12920 SE 38th St; Attn: EPA Compliance 12920 SE 38th St; Attn: EPA Compliance 113 <br /> Bellevue, WA 98006 Bellevue, WA 98006 114, 115,116 <br /> Work phone 425-383-8379 4253838379 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0017758 <br /> Facility name T MOBILE STOCKTON AIRPORT SWITCH T MOBILE STOCKTON AIRPORT SWITCH 3 <br /> Site address 6750 S LONGE ST 6750 S LONGE ST STE 103 <br /> City STOCKTON STOCKTON 104 <br /> ZIP code 95206 95206 105 <br /> Facility phone 425-383-8379 4253838379 102 <br /> Facility mailing address 12920 SE 38TH ST Attn: EPA Compliance 12920 SE 38TH ST Attn: EPA Compliance 108a <br /> BELLEVUE, WA 98006 BELLEVUE, WA 98006 10eb,10ec,toed <br /> BILLING INFORMATION <br /> Contact name T-Mobile USA, Inc Attn: EPACompliance / T-Mobile USA, Inc Attn: EPA Compliance 140 <br /> Address 12920 SE 38TH ST ✓ 12920 SE 38TH ST 143 <br /> BELLEVUE, WA 98006 BELLEVUE, WA 98006 144, 145, 146 <br /> Contact phone 425-383-8379 4253838379 141 <br /> Contact email EPACompliance@t-mobile.com EPACompliance@t-mobile.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: OJ Date: <br /> -------------------------------------------------- <br /> Accounting: Reviewed by: ! t Date: SI N 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 /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location PR0526237 JAMIE DE LA ROSA Active [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO533503 not assigned Inactive [ ] [ ] <br />