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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH uEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run' 4/8/2015 <br />Submitted on: 3/17/2015 10:33:OOPM <br />Submitted by: Donna Kellison Email: Donna.Kellison@T-Mobile.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 />OW0020483 <br />T -MOBILE WEST CORPORATION <br />12920 SE 38th Street <br />Bellevue, WA 98006 <br />425-383-4000 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0022729 <br />Facility name <br />METRO -PCS SC90174M <br />Site address <br />125 N Stockton St <br />City <br />Lodi <br />ZIP code <br />95240 <br />Facility phone <br />888-662-4662 <br />Facility mailing address 1755 Creekside Oaks Dr., Suite 190 <br />Sacramento, CA 95833 <br />BILLING INFORMATION <br />Contact name METRO -PCS SC90174M <br />Address 1755 Creekside Oaks Dr., Suite 190 <br />Sacramento, CA 95833 <br />Contact phone 916-643-8979 <br />Contact email Michelle. Steffler@T-Mobile.com <br />Mail invoices to Account <br />CERS ID: 10609618 <br />Facility ID in CERS: incorrect <br />Information after CIW processing CERS <br />(current submittal) field <br />T -MOBILE WEST, LLC 111 <br />12920 SE 38th Street 113 <br />Bellevue, WA 98006 114, 115, 116 <br />(425) 383-4000 112 <br />METRO -PCS SC90174M 3 <br />125 N Stockton St 103 <br />Lodi 104 <br />95240 105 <br />(888) 662-4662 102 <br />1755 Creekside Oaks, Suite 190 108a <br />Sacramento, CA 95833 108b, 108c, 1084 <br />Michelle Steffler 140 <br />1755 Creekside Oaks, Suite 190 143 <br />Sacramento, CA 95833 144, 145,146 <br />(916) 643-8979 141 <br />Michelle. Steffler@T-Mobile.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: Date: <br />Accounting: Reviewed by: ��11 Date: 015 (- Clerical: File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name Status Reactivated Ina i ed <br />1921 - HMBP-Regular-Primary Location PR0539727 JAMIE DE LA ROSA Active I I <br />