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SAN JOAQUIN BOUNTY ENVIRONMENTAL HEALTH LC-PARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 1/5/2015 <br />Submitted on: 12/9/2014 7:28:23PM <br />Submitted by: Donna Kellison Email: Donna.Kellison@T-Mobile.com <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 />OW0016711 <br />T -MOBILE WEST CORPORATION <br />12920 SE 38th Street <br />Bellevue, WA 98006 <br />425-383-4000 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0020353 <br />Facility name <br />METRO PCS SAC -010 <br />Site address <br />50 W TURNER RD <br />City <br />LODI <br />ZIP code <br />95240 <br />Facility phone <br />888-313-0188 <br />Facility mailing address <br />785 ORCHARD DR <br />FOLSOM, CA 95630 <br />BILLING INFORMATION <br />Contact name <br />METRO PCS SAC -010 <br />Address <br />785 ORCHARD DR <br />FOLSOM, CA 95630 <br />Contact phone <br />916-984-2652 <br />Contact email <br />apinvoices@metropcs.com <br />Mail invoices to <br />Owner <br />CERS ID: 10609621 <br />Facility ID in CERS: incorrect <br />Information after CIW processing CERS <br />(current submittal) field <br />T -MOBILE WEST CORPORATION 111 <br />12920 SE 38th Street 113 <br />Bellevue, WA 98006 114, 115, 116 <br />(425) 383-4000 112 <br />METRO -PCS SAC010 3 <br />50 Turner Rd 103 <br />Lodi 104 <br />95242 105 <br />888-662-4662 102 <br />1755 Creekside Oaks Dr., Suite 190 108a <br />Sacramento, CA 95833 108b, 108c, 108d <br />Michelle Steffler 140 <br />1755 Creekside Oaks Dr., Suite 190 143 <br />Sacramento, CA 95833 144, 145, 146 <br />(916) 643-8979 141 <br />Michelle.Steffler@T-Mobile.com 142 <br />Program record [ ] HMBP [ ] SOG HW [ ] LOG 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: XA Date: • 5 <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 />Program Element and Description Record ID Employee name Status Reactivated Inactivated <br />1921 - HMBP-Regular-Primary Location PR0535238 JAMIE DE LA ROSA Active [ ] [ ] <br />ERSC - ELECTRONIC REPORTING STATE SURCHARGE FI PR0535300 not assigned Inactive [ ] [ ] <br />