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ARCHIVED REPORTS_XR0008533
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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W
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WATERLOO
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4315
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3500 - Local Oversight Program
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PR0545859
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ARCHIVED REPORTS_XR0008533
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Entry Properties
Last modified
6/3/2020 5:14:24 PM
Creation date
8/15/2019 11:59:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008533
RECORD_ID
PR0545859
PE
3528
FACILITY_ID
FA0003831
FACILITY_NAME
WATERLOO FOODMART
STREET_NUMBER
4315
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215-2305
APN
08710034
CURRENT_STATUS
02
SITE_LOCATION
4315 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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Tags
EHD - Public
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' SENT �BY:Xerox Telecopier 7021 ;11— 8-94 ; 9:55 ; 2094561057♦ 011 916 786 78304 5 <br /> WASTE PROFILE FORM <br /> VIZASD"Am AND xxrvxN 7v:FORA'. xpbc,P.O.Box633 snxr nN, CA 9=7F"(25)40W? 466.4x2 <br /> Lr <br /> A. ValiviM./IMn"aNW �L !� I � `y <br /> Generator Name: 5 6a 0 .� BWing Name: <br />' Mulling Ad o L3 BiIDng Address: <br /> City: (.ohc4f State: 6A Zip:�.-- n <br /> City: State; ztp: <br /> Rep r ve: .ti Z Title: Repreaentatim Title: <br /> Trlephone No.: frim � G+Y[a Far Na: Telephone No. Fos No.: <br />' Consultant Name: k C.A T Trmsporter. VY)C^ ,,.i <br /> Mailing Address: 033 5•.: o Melling Address:__8574- rE pc... C^!} v,! _ <br />' City:_ yc u,its Staff.(js -Zlp: g t ��, Cityr State: taq- 73p: 4s t 3 <br /> Repr euntadlve: Title &<-r k&s L . Title: <br /> Telephone Na: df/a2 Ita-z Fax No.: phone Na:R i*- FaK Na: Tod- Y 3 <br />' B.WABn STREAM DZN MCATION <br /> Site Address: a �� <br />' Description of <br /> Process generating vraste: _fc sT r+tw.ea+. * n ykf I,+vim. <br />' C.WAM STREAM DFSCMMQN <br /> L Waste Type: oil ❑ Sludge ❑ Ash ❑ Treated Wood ❑ Debru ❑ Asbestos ❑ Other <br /> L Anticipated Vohune: Tom L1 I,? Cubic Yards 0 of Drums Other <br /> ethod of Shipment: Bulk solid ❑ Containerized d Drums 4.DOT Proper Shipping Name: <br /> Whipping Frequency: ❑ Monthly ❑ Yearly 0 One Time 0 Other <br /> 6.Asbestos Containu t Method: ❑ Bags ❑ Cartons ❑ Drums ❑ Wrapped 0 Other <br />'7.Physical,State: Solid ❑ Slurry ❑Paste ❑ Powder ❑ Other S.Percent Moisture: <br /> 9. Odor. 0 Strong ❑ Mild 9 Now 10.Calor of Material: 11.pH: <br /> 12. Soil Type: %_„wand 21! Silt Clay 13. Free Standing Liquids: ❑ Yes jd No <br /> d Pu 9(%� <br />'D. ANALYT;CAL SUMMARY(AT rmm ALL Cszrnmm LAS REsmTB AND Cmux OF CusToDY DocumarrrATION) <br /> TOTAL PETROLEUM AVG HIGH Units BTEX(SPA 8820) AVG HIGH Units <br /> HYDROCARBONS (Ppm (ppm <br /> (Soedfy Method-e.& 601 b /Opu <br /> Gasoline 4• + rt Benzene ap L p + <br /> Diesel Tohrene 1 <br /> Mater Oil or TOG Eth lbeezene p . <br /> Other: Xylenes v o <br /> VOLATUX ORGANICS SEMI-VOIATME <br /> S�ecity Method-e g.9260) ORGANICS (EPA 8270) <br /> Detected Mal List Detected Aa : <br /> Anslydcai Methods: Other Analytical Methods: <br />
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