My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS XR0000689
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
C
>
CAPITOL
>
6421
>
2900 - Site Mitigation Program
>
PR0522496
>
ARCHIVED REPORTS XR0000689
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
2/15/2019 9:44:24 PM
Creation date
2/15/2019 4:07:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000689
RECORD_ID
PR0522496
PE
2957
FACILITY_ID
FA0015317
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95245
APN
05532024
CURRENT_STATUS
02
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
Jump to thumbnail
< previous set
next set >
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
501
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
NON-HAZARDOUS 1 Generators US EPA!D No Manifest Doc No 2 Pagel; <br /> WASTE MANIFEST nZa nom of <br /> 3 Generators Name and Marling Address <br /> cheveron <br /> h,.ry 12 lode , ca - <br /> 4 Generators Phone( ) <br /> x <br /> 5 Transporter 1 Company Name 6 US EPA ID Number A Transporters Phone <br /> _ INVIED 434-0211 <br /> 7 Transporter 2 Company Name 8 US EPA ID Number B Transporters Phone <br /> 9 Designated Facility Name and Site Address 10 US EPA ID Number C Facility s Phone x <br /> znviro tec <br /> t 2980 athens ave <br /> Yncoln ca 9554 _n91 i <br /> 11 Waste Shipping Name and Description t2 Containers 13 14 <br /> � Total Unit <br /> No Type Quantity WVVol <br /> a <br /> non haz waste liquid nos <br /> ,,caste w J <br /> G b ` <br /> E <br /> IN <br /> E <br /> A <br /> A c H <br /> T <br /> k`- O s <br /> R i. <br />}LrL d <br />` I w <br /> D Ad�:efional Descriptions for Ma erlals Listed Above E Handling Codes'or Wasles L sled Above <br />� 1 <br /> %>9A11/e <br /> P <br /> r <br /> 4 15 Special hanoling Inslrt,c+Ors and Addilional Irierr,,a Pon <br />'= emg <br /> f, <br /> abco troy 915-825-3803 <br /> r 16 GENERATOR 5 CERTIFICATION I ccri y ',e e CCe.n�Ld aoo�e Cr r s manr4ect�re ret�,jb cci c de a reoulaticrs o eoorir-prof d sppsai cf az�Pdo s 'acte <br /> r I Pr me rTvped Name SPgnaiu } mor n Day lea - <br /> E2QjL c_ ,�g r=at s " a t� [ <br /> T i 17 Transpc+er 1 Acknc� lecgerne-1 of Recetpt of rsa e -,s <br /> A Pririoo;T�ped Narnie e ✓or 7 D,V r <br /> IN <br /> O 18 Transporter 2 c-noxleooemEni of Receip,of 1,4a e a's <br />` T PPnlediTSpcdName SPgrawre r,Aonh Cay }ear <br /> E <br /> R <br /> 19 0iscrepancy Indicallon Space <br /> F <br /> A _ <br /> C <br /> f <br /> 20 Facility Or,ner or Opera'e Ccrif callor of receipt o' +as'e materials coy eyed by.his mantles'except as noted In Lem 19 <br /> fPrinled,7�ped Name Sign rAonrn Dav rear <br /> an <br /> PnnledbyJ J KELLERSASSOCiATES INC 12-BLS-05 Rev 12198 <br /> Neenah WI 5A957 0368 <br /> ORIGINAL - RETURN TO GENERATOR <br />
The URL can be used to link to this page
Your browser does not support the video tag.