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AMA <br /> SAN JOACI OUNTY ENVIRONMENTAL HEALT EPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 3/17/2015 <br /> Submitted on: 1/23/2015 2:16:26PM CERS ID: 10145391 <br /> Submitted by: Debra Voth Email: Debra.Voth@verizonwireless.com Facility ID in CERS: FA0010441 <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 Wireless 111 <br /> Mailing address 255 Parkshore Drive 255 Parkshore Drive 113 <br /> Folsom, CA 95630 Folsom, CA 95630 114, 115, 116 <br /> Work phone 866-694-2415 8666942415 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010441 <br /> Facility name Verizon Wireless Stockton Central Verizon Wireless Stockton Central 3 <br /> Site address 343 E MAIN ST 343 E Main Street,Suite 817 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95202 95202 105 <br /> Facility phone 866-694-2415 8666942415 102 <br /> Facility mailing address 255 Parkshore Dr 255 Parkshore Drive 108a <br /> Folsom, CA 95630 Folsom, CA 95630 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name VERIZON WIRELESS Environmental Compliance 140 <br /> Address 255 Parkshore DR 255 Parkshore Drive 143 <br /> Folsom, CA 95630 Folsom, CA 95630 144, 145, 146 <br /> Contact phone 866-694-2415 8666942415 141 <br /> Contact email . Armand.Delgado@VerizonWireless.Com Armand.Delgado@VerizonWireless.Com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRAHW New PR#: <br /> created [ j Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this calendar year [ j next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: B1 Date: 3'I7' 13 <br /> -------------------------------------------------- <br /> Accounting: Reviewed by: llfb Date: 3/I 0 14� 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 /> 1926-HMBP-Unstaffed Network Location PR0512729 HAZA SAEED Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO510441 HAZ MAT SJC OES Inactive [ ] [ ] <br />