Laserfiche WebLink
Iell, <br /> UNIFIED PRoGRAm CONSOLIDATED FORM <br /> HAZARDOUS WASTE <br /> REMOTE WASTE CONSOLIDATION SITE ANNUAL NOTIFICATION <br /> Pa„1 . 1 <br /> 0 <br /> ® a. <br /> Initial ❑ It. Rav6N ❑ a Annual <br /> 1. GENERAL INFORMATION <br /> RISINESS NAMRtsww.,FAsxun vA\I¢or oeA-aolM asl.®A+1FACIILITYIDN - r <br /> Vintage Petroleum, Inc. <br /> 11. CONSOLIDATION SITE INFORMATION Formerly <br /> ADORER% 12350 S. Crocker Road (APN191-090-02) "' FACILfTYEPAR)a CAL00028524 <br /> CITY Stockton cit apcoDE 95206 <br /> D ;ttmI Or THE T}?EW RFa'OTrI0(LVIOWS)ANDSOIB('INSIFRO%l WHICHTHFNON.RPRA HAVARDOUS WASTEVIII I.P (OI I.F('TFDi�- <br /> Pow-polel <br /> Used oil and/or oily water and production water generated from Vintage's Ratto wells & <br /> other nearby facilities were consolidated at the above location. The produced water was <br /> disposed of by the injection well. Current EPA# is CAL000306103 <br /> I RIPTION OF THF TYPE OF HAVA0.IafI11S W ASTF THAT M1IAY RF.FOLLFfTFI) <br /> m <br /> Used oil or condinsate build up was regularly picked oil for <br /> recycling by Ramos Oil for recycling on a regular basis. <br /> ..ou -... °-tVFqTI.UMARTF('DoVawONLTIDAu.0 ,, Jr— <br /> < vw baa-douave this - Tl <br /> P .w, ❑ 4. r floor <br /> to-aal, ❑ Yes _--1p No <br /> 111. BASIS FOR NOT NEEDING A FEDERAL PERMIT <br /> rca-aeaamseor. _ — m <br /> A., <br /> Ka I he huudnus waste hemp cnnsMeWmA u riot hnzvdous suits¢undtr hderal law although Ila;wmle is reguLtal nit hazanlnm wade urakr <br /> CPlifmnn state.law - <br /> ❑ b- The hazmdous waste is hazardous waste under foleral law,but transportation(.and muumulation at the consolidation sue of the waste is net <br /> subject to permitting regmtem-os under federal law Pot the folbwmg other reasonfs). <br /> IV.CERTIFICATIONS <br /> I rentfy totterpenaltyoffswthatthewhvhindeserihod'nthesedocuments meet theapplicableeligiNlit andnpamfing ro)uimmmuofslate sdtmes andregulabom <br /> Ian mrt4te wasw and cono bidelion sites. I further certify then this documcnl and all attach wuur were prepared under my direction or supervsion to aerurdance with a <br /> system designed to mass,that qualified personnel properly gather and evaluak the infolmatioo submitted. Based on my inquiry of the person or persons who hostage <br /> the syst-n,or those directly responsible for gathering the mfmmatbn,the rtfmmation k.to the best of my knowledge and belief,hue,accurate.and complete. I am <br /> aware that tllve are sub9vnal penalties for s,or aing false mforreuon,nclmling the possibility orfinerand imprisamrknt fm knowing viularotu. <br /> SIGNATUREOWNF.RIOPERATOR DATE rw <br /> 3-20-11 <br /> NAME OF OWNEWOPFRATOR(Print) isl I I'rt.F.OF OWNEMPERA'[OR %n <br /> Jeff Monroe Contracted Environmental Compliance Ag M <br /> IJPCF(12/99 revised) 37 Formerly D'rSC 1196 <br />