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EHD Program Facility Records by Street Name
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1900 - Hazardous Materials Program
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PR0540417
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Entry Properties
Last modified
7/26/2018 10:01:56 AM
Creation date
7/26/2018 10:01:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
BILLING
RECORD_ID
PR0540417
PE
1618
FACILITY_ID
FA0023094
FACILITY_NAME
Dollar General # 15928
STREET_NUMBER
12984
STREET_NAME
BLOSSOM
STREET_TYPE
Ct
City
Lockeford
Zip
95237
CURRENT_STATUS
01
SITE_LOCATION
12984 Blossom Ct
QC Status
Approved
Scanner
EJimenez
Tags
EHD - Public
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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 11/3/2015 <br />Submitted on: 10/26/2015 1:43:14PM CERS ID: 10646257 <br />Submitted by: Ken Dobias Email: ken.dobias@questrmg.com Facility ID in CERS: incorrect <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 />Number of Facilities for this Owner : 11 <br />OW0000531 <br />DOLGEN CALIFORNIA, LLC <br />100 MISSION RIDGE <br />GOODLETTSVILLE, TN 37072 <br />615-855-4638 <br />FACILITY FILE INFORMATION <br />Facility ID <br />FA0023094 <br />Facility name <br />DOLLAR GENERAL STORE #15928 <br />Site address <br />12984 E BLOSSOM CT <br />City <br />LOCKEFORD <br />ZIP code <br />95237 <br />Facility phone <br />615-855-4781 <br />Facility mailing address 100 MISSION RIDGE <br />GOODLETTSVILLE, TN 37072 <br />BILLING INFORMATION <br />Contact name DOLLAR GENERAL STORE #15928 <br />Address 100 MISSION RIDGE <br />GOODLETTSVILLE, TN 37072 <br />Contact phone Not Specified <br />Contact email <br />Mail invoices to Facility <br />Information after CIW processing CERS <br />(current submittal) field <br />Dolgen California, LLC 111 <br />100 Mission Ridge 113 <br />Goodlettsville, TN 37072 114, 115, 116 <br />615-855-4024 112 <br />Dollar General # 15928 3 <br />12984 Blossom Ct 103 <br />Lockeford 104 <br />95237 105 <br />209-727-2100 102 <br />100 Mission Ridge 108a <br />Goodlettsville, TN 37072 108b. 108c. 1084 <br />Eric Voyles 140 <br />100 Mission Ridge 143 <br />Goodlettsville, TN 37072 144, 145, 146 <br />615-855-4024 141 <br />wmanagem@dollargeneral.com 142 <br />Program record 1 HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: L{ Ds -(p i <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: i 2 t <br />Assigned to: nL uPr (20:'�f) <br />Please bill: [ ] full calendar year [ ] prorate this calendar year next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: Date: <br />Accounting: Reviewed by: tb Date: �✓� �� Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />[Acct billed T� r^"ar;�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 />1618 - RETAIL MKT >2000 SQ FT (PREPKGD / LTD PREP) PR0540417 JEFFREY WONG Active 11 11 <br />
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