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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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E
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EL DORADO
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1901
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2200 - Hazardous Waste Program
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PR0521759
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COMPLIANCE INFO_PRE 2019
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Last modified
9/21/2020 4:57:17 PM
Creation date
9/21/2020 3:30:37 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0521759
PE
2220
FACILITY_ID
FA0001946
FACILITY_NAME
El Dorado Food Mart
STREET_NUMBER
1901
Direction
S
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
16508019
CURRENT_STATUS
01
SITE_LOCATION
1901 S EL DORADO ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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State of California—California Environmental Protection Agency Department of Toxic Substances Control <br /> GISS,P.0 Box 806 <br /> Sacramento CA 95812-0806 <br /> Item 57 Check this box to change the name of your business for the ID number shown. Please <br /> complete item 7 and 8_ You may update this information as long as there has not been a <br /> change in ownership. If you have had a change in ownership, go to item 1. <br /> Item 6: Enter the legal name of the site/facility/business. Also include a DBA(Doing Business As) <br /> or fictitious business name, if you have one. <br /> Itgm 7: Enter the ite/business location address, including county name. The address must be a <br /> physical address; street number and street name. If there is no street number and street name, <br /> latitude and longitude or Assessors Parcel Number(APN) may be used. Post Office boxes or <br /> descriptive addresses are not acceptable as a site location_ Please do not abbreviate. <br /> Item 8: (a) Provide the business's Federal Employer Identification Number(FEIN), An FEIN, also <br /> known as a Federal Tax Identification Number, is used to identify a business entity. Go to <br /> www.irs. ov/busin sses/small/article/0 id=98354 00.html for additional information or call <br /> (800) 829-4933. An FEIN is usually written 00-00000000. (b) If the business has a Board of <br /> Equalization (BOE')fee account number, also known as a hazardous waste generator fee account <br /> number, please p vide it. If the business does not have a BOE fee account number leave this <br /> space blank. A 139E number is only required if the business generates or produces five or more <br /> tons of hazardous(waste per calendar year, regardless of the final disposition of the waste. If you <br /> meet this criteria and do not have a number, please contact BOE at (916) 323-9534 or visit their <br /> website at www,bg e.ca.gov. <br /> Item : Provide the site/business mailing address. The mailing address may be different from the <br /> location address. <br /> Item 10: Enter the site contact person's information. Select your preferred primary communication <br /> method, mail or email. <br /> Item 11: Enter the legal business owners information_ Use a company name if the business is a <br /> corporation or provide the owner's name if the business is a sole proprietorship. Do not list the <br /> property owner oranagement company, if they are not the entity generating the hazardous <br /> waste. Please pro ide the owner's address, and phone and fax numbers. <br /> Item 12: Enter the -digit Standard Industrial Classification Code (SIC). The SIC Code is a four- <br /> digit number that b st describes your company's primary business activity, If your company's SIC <br /> Code is unknown, o to the Internet at:www.osha.gov/oshstat*/sieser.html to search for the Code. <br /> You may find it helful to follow the online link'examine the manual structure'. <br /> Item : Sign and:ate. <br /> 9 <br /> Common SIC Codes <br /> 3599 - Machine Shap 5541 -Gas Station <br /> 5511 - Car Dealer 7532-Auto Body Shop <br /> 7538 - uto Repair(general) 7623- Refriger. &Air Conditioning Repair <br /> 8021 - ental Office 7212- Da Cleaner <br /> Instrudons for DISC Form 13S�(6/08) Page 3 of 4 <br /> CT/BT 39Cd SbOgJdH NV3-10 ZL9S89VG0Z ZZ :ZT 0Tl3Z/Le/S0 <br />
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