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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALT PARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 1/21/2016 <br /> Submitted on: 1/4/2016 2:20:50PM CERS ID: 10207267 <br /> Submitted by: Gina Pimentel Email: gina.pimentel@stantec.com Facility ID in CERS: FA0005003 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 1 <br /> Owner ID OW0002840 <br /> Owner name Verizon California Inc. Verizon California Inc. 111 <br /> Mailing address 280 S. Locust Street 280 S. Locust Street 113 <br /> Pomona, CA 91766 Pomona, CA 91766 114, 115, 116 <br /> Work phone 909-620-5498 909-620-5498 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0005003 <br /> Facility name Verizon California: Manteca PY Verizon California: Manteca PY 3 <br /> Site address 17855 Comconex Rd 17855 Comconex Rd 103 <br /> City Manteca Manteca 104 <br /> ZIP code 95336 95336 105 <br /> Facility phone 209-825-9301 209-825-9301 102 <br /> Facility mailing address 280 S. Locust Street 280 S. Locust Street 108a <br /> Pomona, CA 91766 Pomona, CA 91766 1081b,108c,108d <br /> BILLING INFORMATION <br /> Contact name VERIZON CALIFORNIA Zachary Feingold 140 <br /> Address 280 S. Locust Street 280 S. Locust Street 143 <br /> Pomona, CA 91766 Pomona, CA 91766 144, 145, 146 <br /> Contact phone 909-620-5498 909-620-5498 141 <br /> Contact email zachary.d.feingold@verizon.com zachary.d.feingold@verizon.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: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] proratethis calendar year [ ] next calendar year [ ] exempt from billing <br /> s <br /> Processed through CERS Integration Wizard by: AA Date: - )A+k�a <br /> -------------------------------------------------- <br /> Accounting: Reviewed by:_b Date: 121 I 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 Inactivated <br /> 1920-HMBP-Common Materials PRO520461 NICHOLAS LOEHRER Active [ ] — <br /> +2220-SM HW GEN<5 TONS/YR PR0538437 ELENA MANZO Active [ ] <br /> 4740-WASTE TIRE SITE-EXEMPT PRO531011 ALFONSO ARAMBULA Active [ ] [ ] <br /> 2381 -UST FACILITY(BEFORE 1/84)-obsolete PRO501149 ALISON YOUNGBLOOD Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0519137 ALISON YOUNGBLOOD Inactive [ ] [ ] <br /> ERSC-ELECTRONIC REPORTING STATE SURCHARGE FI PRO532159 not assigned Inactive [ ] [ ] <br />