To answer the immediate question...

I've also seen the rest of the code on your other posts.  You're accumulating the information for each database in the global temporary table...

If your system has a SAN, most SANs have some option to do a SAN "Snapshot" either as a built in or optional feature.

I still think a restore...

See that DISTINCT?  Figure out which join(s) are causing the need for that and fix it.  That will almost certainly be the root of your performance problem.  If you want...

Hmmm... I haven't tried it but perhaps a BIGINT Sequence would work here.

Put the IDENTITY column back on the table and call it a day. It wasn't as irrelevant as everyone thought.

If finding rows by birth month without regard to year or day is something important, it's probably worthwhile to materialize the birth month in the table using a persisted computed...

It sounds like a classic case of the bad kind of parameter sniffing.  My first step on something that handles that many rows would be to add OPTION (RECOMPILE) to...

The non-premium rates have a charge for every 10,000 "transactions".  They don't define what a transaction is, though, or at least I've not found it yet.  If a "transaction" is...