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AWL <br /> SAN JOAQUI OUNTY ENVIRONMENTAL HEALTH PARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard Date run: 6/12/2015 <br /> Submitted on: 6/4/2015 3:44:12PM CERS ID: 10415389 <br /> Submitted by: Faten Tayeh Email: faten.tayeh@cbi.com Facility]Din CERS: FA0010564 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0008527 <br /> Owner name New Cingular Wireless PCS, LLC dba AT&T New Cingular Wireless PCS, LLC dba AT&T 111 <br /> Mailing address 308 S. Akard St., Room 1708 308 S. Akard St., Room 1708 113 <br /> Dallas, TX 75202 Dallas, TX 75202 114, 115, 116 <br /> Work phone 214-464-2626 214-464-2626 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010564 <br /> Facility name AT&T Mobility-FRENCH CAMP (9834) AT&T Mobility- FRENCH CAMP(9834) 3 <br /> Site address 817 Yettner Rd 817 Yettner Rd 103 <br /> City French Camp French Camp 104 <br /> ZIP code 95231 95231 105 <br /> Facility phone 800-638-2822 8006382822 102 <br /> Facility mailing address PO BOX 5095, RM 4W200 308 S. Akard St., Room 1708 108a <br /> SAN RAMON, CA 94583 Dallas, TX 75202 108b,108c,108d <br /> BILLING INFORMATION <br /> Contact name Manager EH&S EPCRA AT&T Mobility Manager EH&S EPCRA 140 <br /> Address PO BOX 5095, RM 4W200 5001 Executive Pkwy, RM 4W2001 143 <br /> SAN RAMON, CA 94583 San Ramon, CA 94583 144, 145, 146 <br /> Contact phone 925-823-8954 214-464-2626 141 <br /> Contact email g43573@att.com 843573@att.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] 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: av Date: (O.I�-I <br /> -------------------------------------------------- <br /> Accounting: <br /> ----g. ---- --------------------- [ ] [ ] <br /> Accountin Reviewed by: Date: W ioI/I Clerical: X File Relabel file Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ----------------------------- <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Program Element and Descriotion Record ID Employee name Status Reactivated Inactivated <br /> 1926-HMBP-Unstaffed Network Location PRO539162 ROBERT LOPEZ Active, Exempt [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510564 HAZ MAT SJC DES Inactive [ ] [ ] <br />