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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
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EHD - Public
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;�MbNAHAZARDCUS SAIAL WASTE & 17o'13ESTIP <br /> ^. If waste is asbestos waste,complete Sections 1,11,IH and IV. NC - I <br /> If waste is NDJ asbestos waste,complete only Sections I,II and III. <br /> ' �0r <br /> Name: ARCO PRODUCTS COMPANY b. Generating Location: ARCO STATION <br /> POB 5077 J d. Address: 16 E. HARDING <br /> BOEl1U1 PARK, CA 90622-5077 STOCKTON, CA <br /> (925) 299-8891 PAUL SUPPLE f. Phone No.: N/A <br /> 3 generating facility differs from the generator,provide: <br /> ame: <br /> ARCO PRODUCTS COMPANY h. Owner's Phone No.: Same as I(e) <br /> TYPE <br /> E CODE C A 40 5 0 6 1 7 9 9 2 0 9 Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> B -BAG <br /> n of Waste: NON-HAZARDOUS SOIL k. Ouant' Units No. TYPE BA -6 MIL.PLASTIC BAG <br /> 0 0 O LY] O in <br /> M T -TRUCK <br /> O -OTHER or WRAP <br /> OR'S CERTIFICATION: I hereby certify that the above named material is not a hazardous waste as defined by 40 CFR Part 261 or UNITS <br /> able state law, has been properly descritrd, classified and packaged, and is in proper condition for transportation according to P -POUNDS <br /> regulations;AND,If the waste is a treatment residue of a previously restricted hazardous waste subject to the land Disposal Y -YARDS <br /> m'I certify and warrant that the waste has beep V to 'n accordance wit ihG'requirements of 40 CFR Part 266 and is no longer a M' -CUBIC-CUBIC METERS <br /> :waste as defined by 40 CFR Part 261. / a - : �' - e f ARCO P� y Os -OTHER <br /> YARDS <br /> 3A KIRN/ DILLARD <br /> Authorized Agent Name f, irte / Shipment Dolle Ir <br /> " - <br /> ( <br /> �.. c., 4if'Itl IeiETansg. , erator, SQORTER cumpleteat, i� <br /> TR \SPO RI TRAx.NSt*PO.,RTE.�RII <br /> -1 <br /> ek v( h..Name: <br /> �^ \ <br /> I. Address: <br /> C <br /> me/1-Me: t ( j. Driver Name/Title: PRIMlIWE <br /> � rPRIrfTfrYPE <br /> z: <br /> ��� �4.Cd`a e. Truck No.: k. Phone No.: I. Truck No.: <br /> cense No./State: '" f?`f- T In.Vehicle License No./State: <br /> jedgement of Recei tt o�als. Acknowledgement of Receipt of Materials. <br /> 7 ^ n' Ship meet Date <br /> lure SM ment Date Driver S nature - <br /> F l7ESTINAfION (ceneator wmpletasa-d,destina8o it pleCes'�i,)°' <br /> BFI — VASCO ROAD SANIT7cRY LANDFILL a Phone No.: (925) 447-04, <br /> ie: <br /> 4001 N. VASCO Rf),+D4001 N. VASCO ROAD <br /> Address: d. Mailing Address <br /> LIVERMORE, CA 94550 LIVERMORE, CA 94550 <br /> .ncy Indication Space: <br /> certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> j,>B# 1007-114 <br /> —f <br /> FIT= PO# 09-30308 <br />
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