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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-HAZAREOPS SPECIAL WASTE & (72ESTOS MANIFEST <br /> 1f waste is asbestos waste,complete Sections L 11,ID and N. C�,2#48 <br /> ' <br /> tf waste is NOT asbestos waste,complete only Sections L II and mNo. J <br /> . <br /> ggzw- <br /> ERAt k1 « "_Isf ; <br /> a. Generator Name: ARCO PRODUCTS COMPANY b. Generating Location: ARCU STATION 404932 <br /> :. Address POB 5077 d. Address: 16 E. HARDING <br /> SUENA PARR, CA 90622-5077 VrOMn%, CA <br /> a. Phone No.: (925) 299-8891 PAUL SUPPLE I. Phone No.: N/A <br /> !f owner of the generating facility differs from the generator,provide: <br /> 3. Owner's Name: ARCA PRODUCTS COMPANY In. Owner's Phone No.: Sarie as I(e) <br /> TYPE <br /> Cm <br /> BFI WASTE CODE A 4 0 5 [ 0 6 1 7 9 9 2 0 9 Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> B -BAG <br /> NON—HAZARDOUS SOIL k. Quant' units No. TYPE BA -6 MIL.PLASTIC BAG <br /> j. Description of Waste: or WRAP <br /> 0 0 0 / Y0 1 m T -TRUCK <br /> O -OTHER <br /> GENERATOR'S CERTIFICATION: I hereby certify that the above named material is not a hazardous waste as defined by 40 CFA Part 261 or UNITS <br /> any applicable state law, has been properly described,classified and packaged, and is in proper condition for transportation according to P -POUNDS <br /> applicable regulations;AND,If the waste Is a treatment residue of a previously restricted hazardous waste subject to the land Disposal Y r -YARDS <br /> Restrictions,I certify and warrant that the waste has been red p -accordance w' the requirements of 40 CFR Part 268 and is no longer e M -CUBIC METERS <br /> hazardous waste as defined by 40 CFA Part 261. tl. ' Wr e of ARCO PRODUCTS COMPANY Y' -CUBIC YARDS <br /> O -OTHER <br /> MELISSA KIRN/ DILLARD <br /> Generator Authorized Agent Name 77 77, r 4 ni a Shipment Date <br /> $@CYJOIl''Il„x .. ""„-``' ; .„.it..(SAT($P( RTE( {GaleratorcomPleiea-d: 7rman�srterUmmrr����te'h1, `--�., '. .,`iss>-Y:�e.�. :.�sx �-,,v : <br /> TRANSPORTER 1 ' TRANSPORTER II <br /> a. Name: C/,/ rO011 V �!� S h. Name: <br /> b. Address: - � / I. Address: - <br /> c. Driver Name ride: - -�'/ j. Driver Namelfltle: <br /> ) C 1 PRItJfTYPE PRIM/IYPE <br /> d. Phone No.: S L U"➢ e. Truck No.: k. Phone No.: I. Truck No.: <br /> f. Vehicle License No /State, ��7TT m.Vehicle License No./State: <br /> Acknowi gement of Receipt oflAateAals. Acknowledgement of Receipt of Materials. <br /> Z S S <br /> gn, <br /> D S nature Shi merit Date n. Diner Si nature Shipment Date <br /> 77— <br /> G a. <br /> S@bilin T(1 {' `4` ES71NA[ION {GeneatorcomPesd deatnatonsRecdmpletesed) <br /> BFI - VASCO'ROAD SANITARY LANDFILL (925) 447-0491 <br /> a. Site Name: c. Phone No.: <br /> 4001 N. VASCO ROAD 4001 L. VASCO ROAD <br /> b. Physical Address: d. Mailing Address <br /> LIVERMORE, CA 94550 LIV FwIDRE, CA 94550 <br /> e. Discrepancy Indication Space: <br /> I 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 /> f PO# 09-1;308 <br /> f. <br />
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