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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 1//1412014 <br /> Submitted on: 1113!2014 10:56:32AM CERS ID: 10467985 <br /> Submitted by: Amy Smalls Email: asmalls@dollartree.com Facility ID in CERS: FA0022071 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Owner I D OW0006662 <br /> Owner name Dollar Tree Stores, Inc. Dollar Tree Stores, Inc. 111 <br /> Mailing address 500 Volvo Pkwy 500 Volvo Parkway 113 <br /> Chesapeake, VA 23320 Chesapeake, VA 23320 114, 115, 116 <br /> Work phone 757-321-5000 757-321-5000 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0022071 <br /> Facility name Dollar Tree#05403 Dollar Tree#05403 3 <br /> Site address 1209 E March Ln 1209 E March Ln 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95210 95210 105 <br /> Facility phone 209-472-9267 209-472-9267 102 <br /> Facility mailing address 500 Volvo Parkway 500 Volvo Parkway 108a <br /> Chesapeake, VA 23320 Chesapeake, VA 23320 108b,1©ac,load <br /> BILLING INFORMATION <br /> Contact name Dollar Tree Stores, Inc. Amy Smalls 140 <br /> Address 500 Volvo Parkway 500 Volvo Parkway 143 <br /> Chesapeake, VA 23320 Chesapeake, VA 23320 144, 145, 146 <br /> Contact phone 757-321-5000 757-321-5369 141 <br /> Contact emailn asmalls@dollartree.com 142 <br /> Mail invoices to F ility t <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CaIARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] prorate <br /> .this <br /> ,�lcalendar year [ ] next calendar year [ ] exempt from billing <br /> Processed through CERS Integration Wizard by: LMY Date: 11,1%4 � <br /> Accounting: Reviewed by: Date: 1l Cierical:'-�4 File [ ] Relabel file [ ] Create new file <br /> Surchar�erified 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) PRO538196 STEPHANIE RAMIREZ Active [ ] [ ] <br /> 1921 -HMBP-Regular-Primary Location PR0538318 ROBERTLOPEZ Active ( ] [ ] <br /> 2220-SM HW GEN 45 TONSNR PRO538317 FATINAH ZAREEF Active [ ] [ ] <br />