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SAN JOAQUIiv %.:OUNTY ENVIRONMENTAL HEALTH wEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 6/12/2015 <br />Submitted on: 6/5/2015 2:31:45PM CERS ID: 10415392 <br />Submitted by: Julie Anenson Email: julie.anenson@cbi.com Facility ID in CERS: FA0022498 <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, RM 4W200 <br />SAN RAMON, CA 94583 <br />Work phone 925-823-8954 <br />FACILITY FILE INFORMATION <br />Information after CIW processing CERS <br />(current submittal) field <br />New Cingular Wireless PCS, LLC dba AT&T 111 <br />308 S. Akard St., Room 1708 113 <br />Dallas, TX 75202 114, 115,116 <br />214-464-2626 112 <br />Facility ID <br />FA0022498 <br />BILLING INFORMATION <br />Facility name <br />AT&T Mobility - FARMINGTON (9844) <br />AT&T Mobility - FARMINGTON (9844) <br />3 <br />Site address <br />299.9 E HWY 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, RM 4W200 <br />308 S. Akard St., Room 1708 108a <br />Dallas, TX 75202 108b,108c, 108d <br />AT&T Mobility Manager EH&S EPCRA 140 <br />5001 Executive Pkwy, RM 4W2001 143 <br />San Ramon, CA 94583 144, 145, 146 <br />214-464-2626 141 <br />g43573@att.com 142 <br />Program record [ J HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] 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: W'v Date: (P- l� I <br />Accounting: Reviewed by: Dater/ �' �� 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 <br />SAN RAMON, CA 94583 <br />BILLING INFORMATION <br />Contact name <br />Manager EH&S EPCRA <br />Address <br />PO BOX 5095, RM 4W200 <br />SAN RAMON, CA 94583 <br />Contact phone <br />925-823-8954 <br />Contact email <br />g43573@att.com <br />Mail invoices to <br />Account <br />308 S. Akard St., Room 1708 108a <br />Dallas, TX 75202 108b,108c, 108d <br />AT&T Mobility Manager EH&S EPCRA 140 <br />5001 Executive Pkwy, RM 4W2001 143 <br />San Ramon, CA 94583 144, 145, 146 <br />214-464-2626 141 <br />g43573@att.com 142 <br />Program record [ J HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] 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: W'v Date: (P- l� I <br />Accounting: Reviewed by: Dater/ �' �� 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 <br />