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3500 - Local Oversight Program
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PR0508502
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SITE HISTORY
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Entry Properties
Last modified
11/6/2018 8:23:15 PM
Creation date
11/6/2018 3:17:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0508502
PE
3526
FACILITY_ID
FA0008117
FACILITY_NAME
ARCO STATION #4932
STREET_NUMBER
16
Direction
E
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95204
APN
13902001
CURRENT_STATUS
01
SITE_LOCATION
16 E HARDING WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
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Tags
EHD - Public
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"NON MAZAR U3 SPECIAL WASTE AL**,TOS MANIFEST <br /> waste Is asbestos waste,complete Sections>.II,III end IV <br /> If waste Is NOT asbestos waste;complete only Sections.L II and III. ` 'Y&"_1512429 <br /> ARCO PRODUCTS tCOMP1ANY ARCD STATION #04932 <br /> 3enerator Name: b. Generating Location, <br /> address POS 5077 d. Address: 16 R. $ARDING <br /> SUM PARK, CA 90622-5077 STOG=W, CA <br /> "hone No.: (925) 299-8891 PAUL SUPPLE f. Phone No.: - N/A <br /> vner of the generating facility differs from the generator,provide: <br /> 3wnees Name: ARCO PRODUCTS COMPANY h. Owner's Phone No.: Same as I(c) <br /> .: TYPE - <br /> 3FI WASTE CODE C A 40 5 0 6 1 7 9 9 0 1 2 1 1 0 9 1 Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> B -BAG <br /> )ascription of Waste: NON-SAZARDOiJS SOLI' k' Oa0 ity 0 0� 0 1 � O -0 UHEor R WRAP nits No. TYPE BA -6 MIL.PLASTIC BAG <br /> GENERATOR'S CERTIFICATION: 1 hereby certify that the above named material is not a hazardous waste as defined by 40 CFR Part 261 or UNITS <br /> any applicable state law, has been property described, classified and packaged,and is in proper condition for transportation according to I P -POUNDS <br /> applicable regulations;AND,If the waste Is a treatment residue of a previously restricted hazardous waste subject to the Land Disposal 1Y -YARDS <br /> Restrictions,I certify and warrant that the waste has beep Bate In accordance with the requirements of 40 CFR Part 268 and is no longer a M' -CUBIC METERS <br /> hazardous waste as defined by 40 CFR Part 261. �,� r e Ue OP -A$CO a� Ya -CUBIC YARDS <br /> f O -OTHER <br /> MMTRRA XTRN/ DTT.T.ARTI _ <br /> Generator Authorized Agent Name re .Mshipment Date <br /> WETS <br /> x , .k- <br /> P 11Sp( RE a�a Isles <br /> TRAN,S('QRTF,�R , - TRANSPORTER II <br /> Jame: h. Name: <br /> tddress: PO twx 4 f( T. �-`� j I. Address: <br /> )river Name/Title: <t(\k-r I z,-+ j. Driver Name/T-Ne: <br /> PIUNT/rYPE PRINT/rYPE <br /> 'hone No.: all - I I LI �. e. Truck No.: �+7 '-i_ k. Phone No.: I. Truck No.: <br /> /chicle License NoJState:f �i J m.Vehicle License No./State: <br /> kcknowledgem 0 e' of Mate 'als. Acknowledgement of Receipt of Materials. <br /> Z2 <br /> /// 0 G 7 n. <br /> Si nature SN em Date Driver Si nature Shipment Date <br /> ESQ INA 100 �4W Don lete4"a tes ti elle ' <br /> ;rte Name: <br /> BFI - VA.4C0 ROAD SANITARY LANDFILL c. Phone No.: (925) 447-0491 <br /> _ <br /> 'hysical Address: 4001 N. VASCO ROAD d. Mailing Address 4001 N. VASCO ROAD <br /> LIVERMORE, CA 94551) LIVERMORE, CA 94550 <br /> tiscrepancy Indication Space: <br /> hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> JO&9 1007-114 <br /> PO# 09-30308 <br /> ame o/Aulhorrzeo Agent Signature ,Receipt Date <br /> C6`y &' x ' ''4 }"'.ASBESTOS tGerie'raio[complete d-tl I dMppeim"comolel a:f <br /> I <br />
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