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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Changes to EnvisionConnect by CERS Integration Wizard Date run: 1/4/2016 Submitted on: 12/31/2015 9:53:51AM CERS ID: 10479931 Submitted by: Mike Larow Email: ml216w@att.com Facility ID in CERS: incorrect OWNER INFORMATION Owner ID Owner name Mailing address Work phone Information prior to CIW processing (current EC database) Number of Facilities for this Owner : 1 OW0020606 New Cingular Wireless PCS, LLC PO BOX 5095, RM 4W200 SAN RAMON, CA 94583 925-823-8954 FACILITY FILE INFORMATION Information after CIW processing CERS (current submittal) field New Cingular Wireless PCS, LLC dba ATE 111 308 S. Akard St., Room 1708 113 Dallas, TX 75202 114, 115, 116 (214)464-2626 112 Facility ID FA0022773 BILLING INFORMATION Facility name AT&T Mobility - WEST LN - E BIANCHI RD i AT&T Mobility - WEST LN - E BIANCHI RC 3 Site address 1120 E March Ln 1120 E March Ln 103 City Stockton Stockton 104 ZIP code 95210 95210 105 Facility phone 800-638-2822 8006382822 102 Facility mailing address PO BOX 5095, RM 4W200 308 S. Akard St., Room 1708 108a Dallas, TX 75202 108b, 108c, 108d AT&T Mobility Manager EH&S EPCRA 140 5001 Executive Pkwy, RM 4W2001 143 San Ramon, CA 94583 144, 145, 146 (214) 464-2626 141 g43573@att.com 142 Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PR#: _ New PE: Assigned to: Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing Processed through CERS Integration Wizard by: Date: I]+!I �' Accounting: Reviewed by: L6 Date: � f tc 11L- Clerical: [ ] File [ ] Relabel file [ ] Create new file [ ] Acct billed [ ] Surcharge verified By: Date: ------------ ------------------- ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW Program Element and Description Record ID Employee name Status Reactivated Inactivated 1921 - HMBP-Regular-Primary Location PR0539810 HAZA SAEED Active [ I [ I SAN RAMON, CA 94583 BILLING INFORMATION Contact name AT&T MOBILITY Address PO BOX 5095, RM 4W200 SAN RAMON, CA 94583 Contact phone 925-823-8954 Contact email g43573@att.com Mail invoices to Account 308 S. Akard St., Room 1708 108a Dallas, TX 75202 108b, 108c, 108d AT&T Mobility Manager EH&S EPCRA 140 5001 Executive Pkwy, RM 4W2001 143 San Ramon, CA 94583 144, 145, 146 (214) 464-2626 141 g43573@att.com 142 Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PR#: _ New PE: Assigned to: Please bill: [ ] full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing Processed through CERS Integration Wizard by: Date: I]+!I �' Accounting: Reviewed by: L6 Date: � f tc 11L- Clerical: [ ] File [ ] Relabel file [ ] Create new file [ ] Acct billed [ ] Surcharge verified By: Date: ------------ ------------------- ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW Program Element and Description Record ID Employee name Status Reactivated Inactivated 1921 - HMBP-Regular-Primary Location PR0539810 HAZA SAEED Active [ I [ I