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ARCHIVED REPORTS_XR0002422
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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G
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GRANT LINE
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450
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3500 - Local Oversight Program
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PR0545201
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ARCHIVED REPORTS_XR0002422
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Entry Properties
Last modified
1/24/2020 4:29:01 PM
Creation date
1/24/2020 4:12:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002422
RECORD_ID
PR0545201
PE
3528
FACILITY_ID
FA0009068
FACILITY_NAME
Green Soap Inc
STREET_NUMBER
450
Direction
E
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
450 E GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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waste o t <br /> No. 916005 -IJ <br /> Systems TM w ' <br /> BROWNING-FERRIS INDUSTRIES I\ bWHAZARDOUS SPECIAL WASTE. MANIFEST <br /> GENERATOR <br /> 1 U rator Name i. 't�i�E; 1 I t7t ILK'�' ; C C�'T'�.s j <br /> Generating Location <br /> Address 454 E. GPAN�.T�' RSDSAME <br /> Address <br /> TRACY, CA 95376SAME <br /> y <br /> 'Phone No. 8 ' 3 5 9 1 3 3 Phorie No. <br /> EIR Waste Code C �{ f b ) `� Z 3 3 Containers Type <br /> # Description of Waste Quantity Units No. T pe 0 -Drum <br /> C-,Parton <br /> FT. I IT 8 z a - Bag <br /> T -Truck <br /> Dm ❑ P - Pounds <br /> Y -Yards <br /> F-1m ❑ 0-Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been property described, <br /> classified and packaged, and is in proper conditi n for tr nsportation according to applicable regulations. <br /> BOB FAG[] MES, PILANP HUMME �) -� U f o Z 6 <br /> Generator Authorized Agent Name. Signature Shipment Data I <br /> Truck No. <br /> Phone No. 2 <br /> N <br /> Transporter ame <br /> . Driver Name (Print) <br /> . I <br /> Address d Vehicle License No./State 2- <br /> I <br /> . i <br /> Vehicle Certification <br /> I hereby certify that the above na ed material was picked up I hereby certify that the above named material was delivered with- <br /> at the generator site listed above, out incident to th estination listed below. <br /> IL 4� <br /> Driver Signature Shipment Dale Driver Signature <br /> Delivery Date <br /> .'A DESTINATION, <br /> Site Name <br /> Phone No. <br /> Address <br /> I hereby certify that the above named material has been accepted and to the be f y knowledge the foregoing is true and accurate. <br /> Namrt Authorized Agent <br /> sial ale ' <br />` PASS CODE <br /> 10/86 <br /> • • BF1260.720 <br /> UNLOADING AREA COPS <br />
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