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AOL <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH EPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/13/2014 <br /> Submifted on: 6112/2014 1'i:57:12AM CERS ID: 10144743 <br /> Submitted by: Debra Voth Email: Debra.Voth@verizonwireless.com Facility ID in CERS: FA0011270 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008734 111 <br /> Owner name Verizon Wireless Verizon Wireless <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 FA0011270 <br /> Facility name VERIZON -PORT CELL SITE Verizon Wire4ess Port of Stockton 103 <br /> Site address 734 WILSHIRE AVE 735 Wilshire Ave <br /> City STOCKTON Stockton 104 <br /> Zip code 95203 95203 105 <br /> Facility phone 925-527-9600 8666942415 102 <br /> Facility mailing address 2785 MITCHELL DR BLDG 9 255 Parkshore Drive 108a <br /> City WALNUT CREEKF�olsom 108b <br /> State CA CA 1080 <br /> Zip code 945981601 95630 108d <br /> BILLING INFORMATION <br /> Contact name VERIZON -PORT CELL SITE Environmental Compliance 140 <br /> Address 2785 MITCHELL DR BLDG 9 ars five 143 <br /> City WALNUT CREEK Fm196 -- 144 <br /> State CA CA f, 145 <br /> Zip code 945981601 146 <br /> Contact phone Not Specified 8666942415 141 <br /> Contact email Armand.Delgado@VerizonWireless.Com 142 <br /> Program record [ ] HMBP [ ] SQG H [ ] LOG 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,calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: v� Date: (',I- ' iLk — <br /> Accounting: Reviewed by: —Date: a Clerical: File [ ] Create new file <br /> [ ] Acc filled [ ] Surc rge verified By: Date: <br /> ACTIVE PRO AM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Description Record ID Employee name Status Reactivated Inactivated <br /> 1926-HMBP-Unstaffed Network Location PR0513558 LOWELLALLEN Active [ l [ l <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PRO511270 HAZ MAT SJC OES Inactive [ ] [ <br />