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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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2200 - Hazardous Waste Program
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PR0536194
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COMPLIANCE INFO_PRE 2019
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Last modified
9/25/2020 11:29:36 AM
Creation date
9/24/2020 4:15:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0536194
PE
2247
FACILITY_ID
FA0015387
FACILITY_NAME
CVS Pharmacy #9830
STREET_NUMBER
6632
STREET_NAME
PACIFIC
STREET_TYPE
Ave
City
Stockton
Zip
95207
APN
08126020
CURRENT_STATUS
01
SITE_LOCATION
6632 Pacific Ave
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
KBlackwell
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EHD - Public
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California Environmental Reporting System(CERS) Business Owner Operator <br /> Facility/Site <br /> VS Pharmacy#9830 CERS ID <br /> 632 Pacific Ave 10184937 <br /> Stockton,CA 95207 <br /> Submittal Status <br /> Submitted on 9/18/2018 by Stephen Horn of CVS Health(Woonsocket,RI) <br /> Comments by submitter:Updated Emergency Contact Information <br /> Identification <br /> Longs Drug Stores California,L.L.C. Beginning Date Ending Date <br /> Aerator Phone Business Phone Business Fax 9/18/2018 1/1/2019 <br /> 401)765-1500 (209)951-6544 (209)478-8895 Dun&Bradstreet SIC Code Primary NAILS <br /> 001338912 5912 446110 <br /> Facility/Site Mailing Address Primary Emergency Contact <br /> VS Health,Attn:Dianne E.Durand,Licensing,One CVS Drive-MC 1160 Verisk 3E <br /> Woonsocket,RI 02895 Title <br /> 4 Hour Emergency Call Center <br /> Business Phone 24-Hour Phone Pager Number <br /> 888)464-2960 (888)464-2960 N/A <br /> Owner iecondary Emergency Contact <br /> ongs Drug Stores California,L.L.C. iophia Garcia <br /> 401)765-1500 ritle <br /> ne CVS Drive tore Manager <br /> oonsocket,RI 02895 lusiness Phone 24-Hour Phone Pager Number <br /> 209)951-6544 (209)639-2561 N/A <br /> filling Contact Environmental Contact <br /> VS Health;Attn:Dianne E.Durand, Licensing Jerisk 3E,Regulatory Services/CVS,Attn:Stephen Horn <br /> 401)770-3315 Dianne.Durand@CVSHealth.com 760)602-8700 Regulatory@verisk3e.com <br /> ne CVS Drive—MC 1160 3207 Grey Hawk Ct.,Ste.200 <br /> oonsocket,RI 02895 arlsbad,CA 92010 <br /> Name of Signer Signer Title Document Preparer <br /> Stephen Horn,Agent for Longs Drug Stores California,L.L.C. Regulatory Compliance Specialist,Verisk 3E Renee Forero-Cook,Agent for Longs Drug Stores <br /> California,L.L.C. <br /> Additional Information <br /> ocally-collected Fields <br /> ome or all of the following fields may be required by your local regulator(s). <br /> Property Owner Assessor Parcel Number(APN) <br /> ongs Drug Stores California,L.L.C. 08126020 <br /> hone Number of Employees <br /> 401)765-1500 26 <br /> Mailing Address Facility ID <br /> ne CVS Drive <br /> Woonsocket,RI 02895 <br /> RECEIVED <br /> OUi 12018 <br /> Printed on 10/10/20183:14 PM ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br />
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