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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> Changes to EnvisionConnect by CERS Integration Wizard <br /> Date run: 4/18/2017 <br /> Submitted on: 2/20/2017 1:16:05PM CERS ID: 10617937 <br /> Submitted by: Angela Jones Email: ajones@dollartree.com Facility ID in CERS: FA0022690 <br /> Information prior to CIW processing Information after CIW processing CERS <br /> OWNER INFORMATION (current EC database) (current submittal) field <br /> Number of Facilities for this Owner: 2 <br /> Owner ID OW0020085 <br /> Owner name Family Dollar Stores Dollar Tree Stores Inc. 111 <br /> Mailing address 500 VOLVO PARKWAY 500 Volvo Parkway 113 <br /> CHESAPEAKE, VA 23320 Chespeake, VA 23320 114, n5, 116 <br /> Work phone 866-377-6420 (757) 321-5000 112 <br /> FACILITY FILE INFORMATION <br /> Facility ID FA0022690 <br /> Facility name Family Dollar Store#11092 Family Dollar Store#11092 3 <br /> Site address 2006 E Mariposa Rd 2006 E Mariposa Rd 103 <br /> City Stockton Stockton 104 <br /> ZIP code 95205 95205 105 <br /> Facility phone 877-577-2669 877-577-2669 102 <br /> Facility mailing address 500 VOLVO PARKWAY 500 Volvo Parkway 108a <br /> CHESAPEAKE, VA 23320 Chespeake, VA 23320 108b,108c,100d <br /> BILLING INFORMATION <br /> Contact name Family Dollar Store#11092 Angela Jones 140 <br /> Address 500 VOLVO PARKWAY 500 Volvo Parkway 143 <br /> CHESAPEAKE, VA 23320 Chespeake, VA 23320 144, 145, 146 <br /> Contact phone Not Specified (757) 321-5761 141 <br /> Contact email ajones@dollartree.com 142 <br /> Mail invoices to Account <br /> Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br /> created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br /> Assigned to: <br /> Please bill: [ ] full calendar year [ ] proratethis calendar year [ j next calendar year [ ] exempt from billing <br /> / <br /> Processed through CERS Integration Wizard by: ,Joy^ #L�— Date: Li -I6-t7 <br /> Accounting: Reviewed by: (fa Date: 001111 Clerical: [ ] File [ ] Relabel file [ ] Create new file <br /> [ ] Acct billed [ ] Surcharge verified By: Date: <br /> ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br /> Record ID Employee name Status Reactivated Inactivated <br /> 1618-RETAIL MKT>2000 SQ FT (PREPKGD/LTD PREP) PR0539650 LEYNA HUYNH Active [ ] [ ] <br /> 2220-SM HW GEN<5 TONS/YR -1 LL ., I _PRO539984 PAULINE MANGRAI Active [ ] [ ] <br /> (D�7(Y17va J� h1 W{�(� 1`ll /n �ar ^"r- ' <br />