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COMPLIANCE INFO PRE 2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2200 - Hazardous Waste Program
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PR0526632
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COMPLIANCE INFO PRE 2019
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Entry Properties
Last modified
9/25/2019 9:07:12 AM
Creation date
11/1/2018 3:58:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0526632
PE
2220
FACILITY_ID
FA0000813
FACILITY_NAME
KMART STORE #4277
STREET_NUMBER
5757
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
10813007
CURRENT_STATUS
02
SITE_LOCATION
5757 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\P\PACIFIC\5757\PR0526632\COMPLIANCE INFO 2002 - 2015 .PDF
QuestysFileName
COMPLIANCE INFO 2002 - 2015
QuestysRecordDate
6/27/2018 10:03:52 PM
QuestysRecordID
3927580
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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Aft AML <br /> Date: 12/29/2006 W BILL OF LADING Page: 1 <br /> r SHIP FROM <br /> Name:'STORE 4277 Bill of Lading Number: 00000000312778 <br /> Address: 5757 PACIFIC AVE <br /> Ciry/State/Zip: STOCKTON,CA-95207 BARCODE SPACE <br /> SID# ® FOR <br /> SHIP TO Carver Name: CENTRAL TRANSPORT INTL <br /> Name: GENCO/KMART 8362 Location#: 62 Trailer Number: <br /> Address: 350 HANSON WAY Seal Number(s): <br /> City/State/Zip: WOODLAND,CA-95776 SCAC: CTII <br /> CID# FOB Pro Number: 555-342121-1 <br /> THIRD PARTY FREIGHT CHARGES BILL TO <br /> Name: GENCO _ I II`` IIII�II�IIIIIII�I��IIII��������IIII <br /> Address: 1400 Lombardi Avenue,Suite 204 <br /> ��!IIII{1�IIl <br /> City/State/Zip: Green Bay,Wisconsin 54304 Freight Charge Terms:( freight charges are prepaid unless marked otherwise ) <br /> SPECIAL INSTRUCTIONS: Prepaid Collect ® 3rd Party <br /> GENCO PALLET RATES TO APPLY Master Bill of Lading with attached underlying Bills of Lading <br /> CUSTOMER ORDER INFORMATION <br /> DOCUMENT NUMBER #PKGS WEIGHT #PALLETS ADDITIONAL SHIPPER INFO <br /> 019477-1 10 450 1 <br /> 019477-2 18 450 1 <br /> 019477-3 9 225 1 I <br /> Batteries Wet,Filled With Acid Haz Class 225 <br /> I <br /> I <br /> I <br /> GRAND TOTAL 37 1350 3 <br /> CARRIER INFORMATION <br /> HANDLING UNIT PACKAGE WEIGHT H.M. COMMODITY DESCRIPTION LTL ONLY <br /> QTY TYPE CITY TYPE (X) HM BATTERY,WET, FILLED WITH ACID NMFC# CLASS <br /> 3 PALLET 37 CTN 1350 HAZ CLASS 8 ID#UN2794 PACKING GROUP PGIII <br /> EMERGENCY RESPONSE PHONE NUMBER 1-800-424-9300 <br /> RECEIVING <br /> STAMP SPACE <br /> 3 PALLET 1 37 CTN 1350 GRAND TOTAL <br /> ere t e ra e s dependent on value,s ippers are required to state specifically in writing the agreed or decFarad GO Amount: <br /> value of the property as follows: Fee Terms! <br /> 'The agreed or declared value of the property is specific ally stated by the shipper to be not exceeding__,__per_" Collect Prepaid Customer check acceptable <br /> RECEIVED,subject to Individually determined rates or contracts that have been agreed upon in writing between the The carrier shall not make delivery of this shipment <br /> carder and shipper,If applicable,otherwise to the rules,classifications and rules that have been established by the without payment of freight and all other lawful charges, <br /> carrier and are available to the shipper,on request,and to all applicable state and federal regulations, X _ Shipper Signature <br /> SHIPPER SIGNATURE/DATE TRAILER LOADED7 EREIGHT COUNTED: CARRIER SIGNATURE/PICKUP DATE ` <br /> This is to certify that the above named materials are property By Shipper By Shipper Carrier acknowledges receipt of packages and required placards. <br /> classified,described,packaged,marked and labeled,and Carrier certifies emergency response Information was made available <br /> are in proper condition for transportation according to the By Driver/Pallets By Driver and/or carrier has the DOT emergency response guidebook or equiv- <br /> ap7=� <br /> rtment of Transportation. By Ddver/Pieces alent documentation In the vehicle. <br /> X Shipper Signature X CarrierSignature <br /> Property described above Is received in good order,except as noted. <br /> Cl TES6-8Gt, IISD2 4JeW-}I -101, =21 LO TT UeC <br />
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