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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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EHD - Public
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at <br /> NON-HAZAREA 'SPECIAL WASTE & IAESTOS MANIFEST <br /> If waste Is asbestos Waste,complete Sections I,it,III and IV. NO-512437 <br /> If waste is NOT asbestos waste,complete only Sections I,U and M. <br /> L Generator Name: ARCO PRODUCTS COMPANY b. Generating Location: ARCO STATION 104932 <br /> :. Address POB 5077 - d. Address: 16 E. AARDING <br /> BUENA PARK, CA 90622-5077 STOCKTON, CA <br /> Phone No.: (925) 299-8891 PAUL SUppLE.,11,SUPPLE.,:, I. Phone No.: N/A <br /> `owner of the generating facility differs from the generator,provide: <br /> I. Owner's Name: ARCO PRODUCTS COMPANY It. Owners Phone No.: Same as I(e) <br /> TYPE <br /> BFI WASTE CODEC <br /> RAF <br /> 0 5 0 6 1 7 9 9 0 2 1 0 9 Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> Description of Waste: NON-BAZARDOUS SOILB -BAG <br /> k. Quantity0 O ' Units No. TYPE BA -T MIL.PLASTIC BAG <br /> or WRAP <br /> 0 1 T T -TRUCK <br /> O -OTHER <br /> GENERATOR'S CERTIFICATION: I hereby certify that the above named material is nota hazardous waste as defined by 40 CFR Part 261 or UNITS <br /> arty applicable state law, has been properly described, residue <br /> end packaged,and is in proper condition for transportation according to P -POUNDS <br /> applicable regulations;AND,a the waste Is t treatment residue of a previously restricted hazardous waste subject to the Land Disposal Y -YARDS <br /> Restrictions,I certify and warrant that the waste hasWeaccordaMnce the requirements of 40 CFR Part 268 d iolonger a M' -CUBIC METERS <br /> hazardous waste as defined by 40 CFR Part 261. OYs -CUBIC YARDS <br /> A KIRK/ T ILLART) u ty 0 -OTHER <br /> Authorized Agent Name Shipment Date <br /> :-�: b3ri'?.`a,='€»a-t T!a 3 Cofillete Bg p a3 '''"-s: <br /> ,*w � SP_OR`i`ER �.i�eneratordomptetaaar�rans ' 777 <br /> TRANSPOSPORTER II <br /> Name:. Y�i I�6 L L A)j f(V h. Name: <br /> Address: ��CI 1 ( 6 <br /> -� � I. Address: <br /> Driver NameTtle: <br /> Driver Name/Trtle[� � - (�f t � I. _ <br /> I' PflItJT(rYPE" G-1 PRIhIT/rYPE <br /> Phone No::, e. Truck No.: - b l . k. Phone No.: I. Truck No.: <br /> y�`'�� <br /> Vehicle License No./State: M.Vehicle License No./State: <br /> Agknowledgement of R j1 eipt of aterials. Acknowledgement of Receipt of Materials. <br /> nI I II TI <br /> ShI Date Driver Si nature �— <br /> Shipment Date <br /> ' "DESTINATION.(Genefaforco ptetes a i daatinatfort,'s to coynp(etes a t) <br /> lite Name: BFI - VASCO ROAD SANITARY LANDFILL (925) 447-0491 <br /> . c. Phone No.: <br /> 'hysical Address: 4�101 N. VASCO ROAD 4001 N. VASCO ROAD <br /> d. Mailing Address <br /> LIV'RMOP_, CA 94550 LIVERMORE, CA 94550 <br /> Ascrepancy 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 /> JOB@ 1007-114 <br /> /r <br /> POIr' 09-30308 <br />
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