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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run' 5/12/2015 <br />Submitted on: 1/15/2015 7:48:13PM <br />Submitted by: Sheila Caballero Email: sheila.caballero@shawgrp.com <br />Information prior to CIW processing <br />OWNER INFORMATION (current EC database) <br />Owner ID OW0020002 <br />Owner name New Cingular Wireless PCS, LLC dba AT&T <br />Mailing address PO BOX 5095, ROOM 3E000 <br />SAN RAMON, CA 94583 <br />Work phone 925-823-8954 <br />FACILITY FILE INFORMATION <br />CERS ID: 10415392 <br />Facility ID in CERS: incorrect <br />Information after CIW processing CERS <br />(current submittal) field <br />New Cingular Wireless PCS, LLC dba AT&T 111 <br />PO BOX 5095, RM 4W200 113 <br />SAN RAMON, CA 94583 114, 115, 116 <br />9258238954 112 <br />Facility ID <br />FA0022498 <br />Facility name <br />AT&T Mobility - FARMINGTON (9844) <br />AT&T Mobility - FARMINGTON (9844) <br />3 <br />Site address <br />29939 E Highway 4 <br />29939 E Highway 4 <br />103 <br />City <br />Farmington <br />Farmington <br />104 <br />ZIP code <br />95230 <br />95230 <br />105 <br />Facility phone <br />800-638-2822 <br />8006382822 <br />102 <br />Facility mailing address PO BOX 5095, ROOM 3E000 <br />SAN RAMON, CA 94583 <br />BILLING INFORMATION <br />Contact name Claudette Altamirano <br />Address PO BOX 5095, ROOM 3E000 <br />SAN RAMON, CA 94583 <br />Contact phone 925-823-8954 <br />Contact email CA696D@ATT.COM <br />Mail invoices to Facility <br />PO BOX 5095, RM 4W200 108a <br />SAN RAMON, CA 94583 108b, 108c, 108d <br />Manager EH&S EPCRA 140 <br />PO BOX 5095, RM 4W200 143 <br />SAN RAMON, CA 94583 144, 145, 146 <br />9258238954 141 <br />843573@att.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 />------------------ <br />Accounting: Reviewed by: V6 Date: S�13��� Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[ ] Acct billed [ ] Surcharge verified By: Date: <br />------------------------------------------ <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 PR0539352 MICHAEL PARISSI Active, Exempt I I I I <br />