My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO PRE 2019
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
M
>
MAIN
>
1515
>
2200 - Hazardous Waste Program
>
PR0514068
>
COMPLIANCE INFO PRE 2019
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/6/2019 10:10:59 PM
Creation date
8/6/2019 12:00:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0514068
PE
2227
FACILITY_ID
FA0009865
FACILITY_NAME
KIA COUNTRY
STREET_NUMBER
1515
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21619005
CURRENT_STATUS
01
SITE_LOCATION
1515 N MAIN ST
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\dsedra
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.
/
443
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
N <br />L <br />N <br />E <br />F <br />�FdM1Nnrlh Cwnhal FxnrwsRvsaN. Suitor 400 eao -s�ao "ii DUNSNO.��lELGIN OFFICE <br />�1 Richardson, T% 750R0 w .safety-kle .corn -. -_ y�- <br />s CUSTOMER NO. <br />FOR SERVICE CALL <br />BRANCH MANAGER <br />DOC. EXP. <br />cn[di PREVIOUS RAtANCE BALOv Ba DAYS • <br />1 -4 -7 •y C•• <br />rZo�I3gl <br />Ll �533�_t��Z <br />/SALES <br />SVC. PIC <br />PROD. P;C <br />1 <br />LOCATION TAX IXEMPTION NUMBER <br />SERVICE DATE REP NO.I CUSTOMER P.O. NUMB I CUSTOMER PRONE a TAX CODE DATE EQPT/PROD ORDERED SERVICE TAX <br />COM .S. TAX PRODUCT TAX <br />•�tsP'1+ca � <br />SERVICE SURVEY SALES TOTAL CHLORINE TEST RESULTS SKOOT SERVICE cwwce PROMO <br />DEPT UNIT PRICE QUANTITY CHARGE CC smicE lana RELEASE NO. <br />PRODUCT NUMBER TAX CHARGE "."`�" rzP 4T4°Ra�Ec' NUMBER TERM - N0. <br />w PESwis Ia..:-., cresr�,. <br />/Sd77 2uf ❑ <br />❑ r; <br />❑ c <br />❑ ❑ <br />❑ ❑ <br />❑ ❑ <br />TANK <br />TOTAL-SERVICE/PRODUCTS CAPACITY <br />••- DATE / 161 <br />E <br />x r £ <br />PRIM NA SIG NAT E <br />DATE <br />X a <br />PRINT NAME SIGNATURE <br />GENERATOR <br />GENERATOR. <br />HAZARDOUS VVASTE <br />IXA&RM1TCATEON • <br />vENICIE <br />FilADST30 <br />aNLv <br />HER <br />VEHICLE <br />orms <br />ONLY ONE : • • <br />I NO PRMo REOUIiED, No HALOGEN TEST <br />2 NO PREWM_ RC -0 IIREEG 1i4LOGEN ISI AT PIGK{q+ <br />2 PREO RECUREO NO HA.OGEN TEST <br />N PREODALREOUIRED, MlUDGEN Tesrnr Puac-UPI <br />• REFER TO REVERSE SIDE FOR DEaMiKkvs <br />MANIFEST NO. USEPA TRANSPORTER 10 NO. <br />S (% <br />GENERATOR USEPA 10 NO. GENERATOR STATE ID NG. <br />CESOG <br />❑ i <br />3 <br />SOG/LQG <br />❑ 2 <br />1 ❑ 4 I <br />1 Y. US DOT DESCRIPTION IINCLUDING PROPER SHIPPING AME, HAZARD CLASS, AND ID.) <br />12. WWAI1 <br />S <br />a Toru <br />Ill Dor mA@rn <br />a=.., .. <br />r,"''"` <br />WWWE.r <br />F <br />WZ <br />>t�7 <br />Wo <br />WQ <br />>2 <br />ox <br />UV <br />ora <br />d <br />t <br />A <br />ZS <br />� //Z'{9 <br />I RM IAITE <br />FACILITY NAME ND ADDRESS <br />`NA+fS .. / 7 (oC� <br />USA EPA ID NO. <br />N <br />a <br />STATE ID NO. <br />SH E]TOTAL RECEIVED <br />APPLY PAYMENTTO'. <br />CHARGE ACCWNi FOR THIS TRANSACTION UNLESS Mem <br />E PAYMT RECEIVED SECTION. <br />INDICATED RN THEN <br />Curtnr mCar Ne ty mw.mW mrwM w yaper9 c�eLe. dmNa. pmptl +w <br />eq btlN. egwiiPge �r•b Tu 9mWn �gM�WN�AM <br />N.B. Emvmrn>..r/ Prwenun Agyy a+v M U 6. MpveM k irk <br />ADDITIONAL TERNS AND CONDITIONS ON THE REVERSE SIDE OF THIS <br />DO ARE INCORPORATE,,DD� HEREWITH MADE A PART HEREOF. <br />TOTAL DUE �- % J %7 e•('� FA <br />`( (—✓ �i <br />-_Y:_. <br />tr ECK NUMBER <br />❑ Ta6cY48FAMLESAL <br />❑PP[NOUS6AMk^.E.lSfl)LLCN9 <br />INVOICE# AMOUNTS INVOICE# AMOUNTS <br />PREVIOUSMANIFEST <br />CREDIT _. .. .. _y�s�'I <br />CARD NO <br />CODE WO_ <br />= <br />aoreAA <br />kw, e� <br />g18HIPP9i0E910HATf9iffP Al1YE 5pNAilIRE <br />CUSTOMER REFEREN(:E <br />INFORMATION <br />I <br />I <br />SEE REVERSE SIDE FOR IMPORTANT INFORMATION <br />
The URL can be used to link to this page
Your browser does not support the video tag.