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E- SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 6/12/2014 <br /> Submitted on: 1/28/2014 11:35:36AM CERS ID: 10141443 <br /> Submitted by: Steve Skanderson Email: steve.skanderson@stantec.com Facility ID in CERS: FA0010734 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008734 <br /> Owner name Verizon Wireless VERIZON CALIFORNIA INC 111 <br /> Mailing address 255 Parkshore Drive 280 S. Locust St 113 <br /> City Folsom Pomona 114 <br /> State CA CA 115 <br /> ZIP code 95630 91766 116 <br /> Work phone 866-694-2415 909-620-5498 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010734 <br /> Facility name VERIZON WIRELESS INC Verizon California: Lathrop CO 3 <br /> Site address 1265 N ST 1265 N St 103 <br /> City LATHROP Lathrop 104 <br /> Zip code 95330 95330 105 <br /> Facility phone 180-318-891 209-858-0700 102 <br /> Facility mailing address 2785 MITCHELL DR 280 S. Lucust Street 108a <br /> BLDG 9 - 1ST FLOOR <br /> City WALNUT CREEK Pomona 108b <br /> State CA CA 108c <br /> Zip code 94598 91766 108d <br /> BILLING INFORMATION <br /> Contact name VERIZON WIRELESS INC Zachary Feingold 140 <br /> Address 2785 MITCHELL DR 280 S. Locust St 143 <br /> City WALNUT CREEK Pomona 144 <br /> State CA CA 145 <br /> Zip code 94598 91766 146 <br /> Contact phone 925-279-6364 909-620-5498 141 <br /> Contact email zachary.d.feingold@verizon.com 142 <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRAHW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] 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: kxT Date: <br /> -------------------------------------------------- <br /> Accounting: Reviewed by__I Date: Clerical: Wile [ ] Create new file <br /> [ ] AceYC-i[Ied [ ] Surcda a verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1926-HMBP-Unstaffed Network Location PRO513022 MICHAEL PARISSI Active [ ] [ ] <br /> 2226-CaIARP PROGRAM PR0514848 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO510734 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2840-AST EXEMPT FAC <1,320 GAL PRO528141 THUY TRAN Active,Exempt [ ] [ ] <br />