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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTRi DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 7/9/2014 <br /> Submitted on: 3/312014 9:11:06AM CERS ID: 10413070 <br /> Submitted by: Ashley Campbell Email: ashley.campbel9@pscnow.com Facility ID in CERS: FA0010801 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner ID OW0000531 <br /> Owner name DOLLEN CALIFORNIA, LLC DOLLEN CALIFORNIA, LLC 111 <br /> Mailing address 100 MISSION RIDGE 100 MISSION RIDGE 113 <br /> GOODLETTSVILLE, TN 37072 GOODLETTSVILLE, TN 37072 114, 115, 116 <br /> Work phone 615-855-4638 6158554638 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0010801 <br /> Facility name DOLLAR GENERAL#14130 Dollar General #14130 3 <br /> Site address 4115 N EL DORADO ST 4115 N EI Dorado St 103 <br /> City STOCKTON Stockton 104 <br /> Zip code 95204 95204 105 <br /> Facility phone 615-855-4781 (209) 774-9073 102 <br /> Facility mailing address 100 MISSION RIDGIF 100 MISSION RIDGE 108a <br /> GOODLETTSVILLE, TN 37072 GOODLETTSVILLE, TN 37072 108b,108c,land <br /> BILLING INFORMATION <br /> Contact name DOLGEN CALIFORNIA ERIN HOLLOWAY 140 <br /> Address 100 MISSION RIDGF 100 MISSION RIDGE 143 <br /> GOODLETTSVILLE, TN 37072 GOODLETTSVILLE, TN 37072 144, 145, 146 <br /> Contact phone 615-855-4781 6158554638 141 <br /> Contact email WMANAGEM@DOLLARGENERAL.COM 142 <br /> Mail invoices to Account <br /> Program record j}HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: P <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: 1 Ztt7---- <br /> Please bill: [full calendar year [ ] prorate this calendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: Date:Ll <br /> Accounting: Reviewed by: _ 1A Date: I t Clerical: [ J 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 Descri tp ion Record ID Employee name Status Reactivated Inactivated <br /> 1618-RETAIL MKT>2000 SO FT (PREPKGD I LTD PREP) PRO537499 MARIBEL FLOHRSCHUTZ Active [ ] [ ] <br /> 2220-SM HW GEN =5 TONS/YR PR0537834 STACY RIVERA Active [ ] [ ] <br /> 2399-UNIFIED PROGRAM FAC STATE SURCHARGE FEE PR0510801 HAZ MAT SJC OES Inactive [ ] [ ] <br /> 2, <br />