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Alk <br /> SAN JOAQUI COUNTY ENVIRONMENTAL HEALTH EPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/13/2014 <br /> Submitted on: 6/1212014 12:59:13PM 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 /> City Folsom Folsom 114 <br /> State CA CA 115 <br /> ZIP code 95630 95630 116 <br /> Work phone 866-694-2415 8666942415 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010441 <br /> Facility name VERIZON WIRELESS-CENTRAL STKN CE 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 209-467-3847 8666942415 102 <br /> Facility mailing address 2785 MITCHELL DR 255 Parkshore Drive 108a <br /> BLDG 9 - 1ST FLOOR —' <br /> City WALNUT CREEK Fols 108b <br /> State CA 108c <br /> Zip code 94598 5630 108d <br /> BILLING INFORMATION <br /> Contact name VERIZON WIRELESS-CENTRAL STKN CE Environmental Compliance 140 <br /> Address 2785 MITCHELL DR 255 Parkshore Drive 143 <br /> City WALNUT CREEK Fo som 144 <br /> State CA a:- 145 <br /> Zip code 94598 95630 146 <br /> Contact phone 925-279-6364 8666942415 141 <br /> Contact email /V/� Armand.Delgado@VerizonWireless.Corn 142 <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 [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integratio''n,,¢Wiizard by: _ \xt� —Date: <br /> Accounting: Reviewed by: �J Date: 91`� 1 Clerical: �ile [ ] Create new file <br /> Iled [ ] Surch erified By: Date: <br /> ------------ <br /> ACTIVE PRO M RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1926-HMBP-Unstaffed Network Location PRO512729 LOWELLALLEN Active I I I1 <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510441 HAZ MAT SJC DES Inactive I I I 1 <br />