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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 12/6/2016 <br />Submitted on: 12/1/2016 10:27:48AM CERS ID: 10406071 <br />Submitted by: Layheab Ly Email: layheab.ly@americantower.com Facility ID in CERS: FA0022141 <br />OWNER INFORMATION <br />Owner ID <br />Owner name <br />Mailing address <br />Work phone <br />Information prior to CIW processing <br />(current EC database) <br />Number of Facilities for this Owner : 32 <br />OW0009900 <br />AMERICAN TOWERS - EH&S Dept. <br />10 Presidential Way <br />Woburn, MA 01801 <br />602-999-5139 <br />FACILITY FILE INFORMATION <br />Information after CIW processing CERS <br />(current submittal) field <br />AMERICAN TOWERS - EH&S Dept. 111 <br />10 Presidential Way 113 <br />Woburn, MA 01801 114, 115, 116 <br />602-999-5139 112 <br />Facility ID <br />FA0022141 <br />10 Presidential Way <br />108a <br />Facility name <br />American Towers- Manteca Central Rebuild, <br />American Towers- Manteca Central Rebuild, Sil <br />3 <br />Site address <br />318 N Maple Ave <br />318 N Maple Ave <br />103 <br />City <br />Manteca <br />Manteca <br />104 <br />ZIP code <br />95336 <br />95336 <br />105 <br />Facility phone <br />602-284-0280 <br />602-999-5139 <br />102 <br />Facility mailing address <br />10 Presidential Way <br />10 Presidential Way <br />108a <br />Woburn, MA 01801 <br />Woburn, MA 01801 <br />108b, 108c, 108d <br />BILLING INFORMATION <br />Contact name <br />American Towers - EH&S - SITE #265177 - <br />American Towers - EH&S <br />- SITE #265177 - ME 140 <br />Address <br />10 Presidential Way <br />10 Presidential Way <br />143 <br />Woburn, MA 01801 <br />Woburn, MA 01801 <br />144, 145, 146 <br />Contact phone <br />602-284-0280 <br />602-999-5139 <br />141 <br />Contact email <br />scot.sandefur@americantower.com <br />Charmayne.Eriacho@americantower.corr 142 <br />Mail invoices to <br />Account <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW <br />created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] 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: 1-'�- - � 11.6 <br />Accounting: Reviewed by: 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 />O Record ID Employee name Statu Reactivated Inactivated <br />\� <br />�1 6 HMBP-Remote Network Location C}�chem units PR0538297 NICHOLAS LOEHRER 4, , Exeq�pt [ ] [ ] <br />