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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run' 9/29/2015 <br />Submitted on: 9/25/2015 7:25:23AM CERS ID: 10406071 <br />Submitted by: Jennifer Ruth Email: jennifer.ruth@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 />OW0009900 <br />AMERICAN TOWERS - EH&S Dept. <br />10 Presidential Way <br />Woburn, MA 01801 <br />602-284-0280 <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 />602-284-0280 112 <br />Facility ID <br />FA0022141 <br />Facility name <br />American Towers- Manteca Central Rebuild, <br />American Towers- Manteca Central Rebuild, <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 />602-284-0280 <br />102 <br />Facility mailing address PO Box 63604 <br />Phoenix, AZ 85082 <br />BILLING INFORMATION <br />Contact name American Towers, #265177 <br />Address PO Box 63604 <br />Phoenix, AZ 85082 <br />Contact phone 602-284-0280 <br />Contact email scgt.sandefur@americantower.com <br />Mail invoices to Fability P- <br />10 Presidential Way <br />Woburn, MA 01801 <br />108a <br />108b, 108c, 108d <br />American Towers - EH&S - SITE #265177 140 <br />10 Presidential Way 143 <br />Woburn, MA 01801 144, 145, 146 <br />602-284-0280 141 <br />scot.sandefur@americantower.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: Vim" Date: �' t <br />Accounting: Reviewed by: � Date. S Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />- �—]_Acct billed-----H-3Grc a�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 PR0538297 MICHAEL PARISSI Active, Exempt [ I [ I <br />