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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1/6/2017 <br /> Submitted on: 1/3/2017 10:12:21 PM CERS ID: 10144073 <br /> Submitted by: Debra Voth Email: Debra.Voth@verizonwireless.com Facility ID in CERS: FA0010912 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 89 <br /> Owner ID OW0008734 <br /> Owner name Verizon Wireless Verizon Wireless 111 <br /> Mailing address 295 Parkshore Drive 295 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 FA0010912 <br /> Facility name Verizon Wireless Linden Verizon Wireless Linden 3 <br /> Site address 19445 HWY 26 19445 Hwy 26 19445 E St. 103 <br /> City Linden Linden 104 <br /> ZIP code 95236 95236 105 <br /> Facility phone 866-694-2415 8666942415 102 <br /> Facility mailing address 295 Parkshore Drive 295 Parkshore Drive 108a <br /> Folsom, CA 95630 Folsom, CA 95630 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name Environmental Compliance Environmental Compliance 140 <br /> Address 295 Parkshore Drive 295 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 [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate this <br /> t'h'is (calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: V Date: • 6'1-1 <br /> -- --- --- -------- - - --- ---- -- - ---- - ------------ ------ <br /> Accounting: Reviewed by: (k Date: 1/0V7 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> �G1']'( q, Record ID Employee name Status Reactivated Inactivated <br /> *6-HMBP-Common Materials/hem units PR0513200 HAZA SAEED Active ( ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510912 HAZ MAT SJC OES Inactive [ ] [ ] <br />