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CO0028659
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2500 – Emergency Response Program
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CO0028659
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Entry Properties
Last modified
7/17/2019 4:36:07 PM
Creation date
2/7/2019 1:04:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0028659
PE
2546
FACILITY_NAME
VILLAGE WEST MARINA
STREET_NUMBER
6649
STREET_NAME
EMBARCADERO
STREET_TYPE
DR
City
STOCKTON
Zip
95219
APN
09815004
ENTERED_DATE
7/11/2008 12:00:00 AM
SITE_LOCATION
6649 EMBARCADERO DR
RECEIVED_DATE
7/11/2008 12:00:00 AM
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
ADMIN
Supplemental fields
FilePath
\MIGRATIONS\E\EMBARCADERO\6649\CO0028659.PDF
Tags
EHD - Public
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JUL-24-2008 06:13A FROM: TO:4683433 P.2 <br /> Safety -Kleen <br /> 5400 Legacy Or. v <br /> Cluster 11, Building 3 <br /> Plano, Texas 75024 C <br /> 209.545-1011 v <br /> REFERENCE NOR <br /> CUSTKR# 25385911 VILLAGE WEST MARINA 0036937357 <br /> SERVILE TAX! 0.00000 6649 ENITAREADERO Si1UC WEEK 68-28 s� <br /> CORS TAX. 0,00000 SRVC DATE: 07111/08 15:02 0 <br /> PRODUCT TAX: 0,08000 STOCKTON CA 95219 4. <br /> PHONE 209 951.1551 <br /> PURCHASE ORDER# TAX EXEMPTION NOR <br /> ,PROI)VOT/SERV ICES <br /> SERVICE/ TOTAL <br /> PRODUCT 07Y UNIT PRICC TAX CHARGE � <br /> 100008 FEE, CALIFORNIA FUEL NON TA 1 20,0900 0.00 20,09 <br /> 3369 EMPTY DRUM 55 2 96.0000 15.35 207.36 ; <br /> 80088 875220 INC1NrRATE AQUEOUS L 9 0.0000 0.00 0.00 <br /> STN 40140612 CLEAN 0 SPENT 0 <br /> SERVICE TERM 28 <br /> CAUSE CODE V <br /> 88888 875020 FUEL RLM LIQ >6.00 0 0.0000 0.00 U.0t1 4 <br /> SIN 40251436 CLEAN 0 SPENT 0 <br /> SERVICE TO 12 <br /> CAUSE CONE V 1 <br /> 88888 875060 FUEL BLEND SOLID >5, 2 532 n000 0.00 1064.00 12 <br /> S/N 40141150 CLEAN 0 SPENT 0 v <br /> SERVICE TERM 20 <br /> .... <br /> ....... ............ ....... <br /> ---- C <br /> TDIAt SERVICElPRODUCTS 1276.0900 15.36 1291.45 d i <br /> 115'EPA 1NANSPOR RUT 1 TXROno050930 GENERATOR 10 CAL000273454 <br /> US£PA TRANSPORTER 2 GENERATOR STATE + <br /> MANIFEST TRACKING # 00121602513KS FORM CtML US SK TRACKING n 109593105 p <br /> w <br /> LIS UUI I.LSERIP11ON (INC1.11DIN6 PIWI.Ii SHIPPINU NAML, HALARL) C1ASS, AND 1U s <br /> a <br /> WASTE SOLIDS CONTAINING FLAMMABLE � <br /> LIQUID, N.0.5. (TOLUENE,METHVL ETHYL � <br /> KETONE) 4.1 UN3175 PG 11 <br /> (ERG0133) <br /> TOTAL CONT 2 TVPE I.1M ITL 01V 400 UNIT WTIVOL P SKOOT 50463 <br /> CNT# 80519003635 QTY 200 PROF#40141150 <br /> CNT#80519003637 OTV 200 PROF#40141150 <br /> DESIGNATED FACILITY NAME/ADD11ES5: <br /> SAFETY-KLEEN SYSTEMS, INC. <br /> 1722 MOPER CREEK ROAD <br /> DENTON, TX 75206 ` <br /> USEPA 10 NO fXD077603371 TOTAL CHARGE 1,291.45 E <br /> STATE 10 NO WASE MIN 0.00 <br /> ............. u <br /> TOTAL DUE 1,291.45 <br /> a <br /> r <br /> UNPAID BALANCE THIS RECEIPT 1,291.45 <br /> Machine clean and goad condltion? Yes <br /> Decals in place aril legible? Yes <br /> Fuslble link installed? Yes A <br /> Emergency closing of IId unobstructed? Yes <br /> Machine properly proumled? Yes <br /> Spent salvenl meets acceptancer criteria? Yes IN <br /> Prop 65 warning (Calf, only)? Yes <br /> GENERATOR STATUS 2x0 • 2200 tbslmonth <br />
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