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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 12/19/2017 <br /> Submitted on: 11/2/2017 8:24:45AM CERS ID: 10415401 <br /> Submitted by: Steve Taylor Email: st043d@att.com Facility ID in CERS: FA0010562 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION Number <br /> EC database) (current submittal) field <br /> Number of Facilities for this Owner.- 36 <br /> Owner ID OW0008527 <br /> Owner name New Cingular Wireless PCS, LLC dba AT&T New Cingular Wireless PCS, LLC dba AT&T M 111 <br /> Mailing address 308 S. Akard St., 17th Floor 308 S. Akard St., 17th Floor 113 <br /> Dallas, TX 75202 Dallas, TX 75202 114, 115, 116 <br /> Work phone 214-741-0630 (214)464-1712 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010562 <br /> Facility name AT&T MOBILITY- NORTH STOCKTON (1-11c AT&T Mobility- NORTH STOCKTON (LISID98 3 <br /> Site address 10979 N MICKE GROVE RD 10979 N Micke Grove Rd 103 <br /> City LODI Lodi 104 <br /> ZIP code 95240 95240 105 <br /> Facility phone 800-638-2822 (800) 638-2822 102 <br /> Facility mailing address 308 S. Akard St., 17th Floor 308 S. Akard St., 17th Floor 108a <br /> Dallas, TX 75202 Dallas, TX 75202 108b, 108c,108d <br /> BILLING INFORMATION <br /> Contact name AT&T Mobility Manager EH&S EPCRA AT&T Mobility Manager EH&S EPCRA 140 <br /> Address 5001 Executive Pkwy, Rm 4W200I 5001 Executive Pkwy, Rm 4W2001 143 <br /> San Ramon, CA 94583 San Ramon, CA 94583 144, 145, 146 <br /> Contact phone 214-741-0630 (214)464-1712 141 <br /> Contact email 843573@att.com 843573@att.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ SQG HW [ ] LQG HW [ ] RCRA HW New PR#: o 1,y145j <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: Date: A- <br /> Accounting: Reviewed by: t/ Date: Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> ,[ Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1921 -HMBP-Regular-Primary Location 3 chem units PR0539160 JAMIE LIMA Active I 1 [ I <br /> 2224-HAZ MAT BUSINESS PLAN AUTHORIZATION PR0512850 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR051{}562 HAZ MAT SJC OES Inactive { ] [ ] <br /> �,�,� -3a <br />