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2900 - Site Mitigation Program
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PR0001228
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Entry Properties
Last modified
3/31/2020 3:58:11 PM
Creation date
3/31/2020 3:49:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
WORK PLANS
RECORD_ID
PR0001228
PE
2951
FACILITY_ID
FA0004069
FACILITY_NAME
BREUNERS
STREET_NUMBER
7676
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
08102013
CURRENT_STATUS
02
SITE_LOCATION
7676 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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i <br /> _ f <br /> Waste No. 951505 <br /> Systems - <br /> 4VININb-FERFUSNQN-HAZARDQUS SPELL WASTE MANIFEST <br /> GENERATOR <br /> merator Name ��fS Generating Location <br /> Wrriss. Y" Addr aaa <br /> tont;No. � � � / / Phone No. <br /> Ca <br /> tri <br /> 'I Waxto Cosa T O [� l fl I� �3� ( Gnnl�alnarn r)ru? <br /> De6cription of Wawa _ Guantlt Ut11ls No. T D.C•Crwn <br /> a-Bag <br /> �l%'�'�`k,• C. �S,A, T .zrucK <br /> LI .Yerds <br /> E ' I � ❑ O•citner <br /> I horeby cortify that tho abova namod material d000 not eontaln fro* liquid ac defined by,40 Cl"R Part 480.10 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 properly 008C113e0, <br /> classified end.pae.kaaed, and to in proper condition for transportation according to applicable regulaOorka. <br /> S - i 3 <br /> Preto(AUM(MUSa A"MI?14R* I <br /> TRANSPORTER <br /> uck No. - �L7 Phone <br /> ansporter Name _ t- J Driver Name{Print► <br /> 7dresa U vantde t.lcenl+•B s+loJsteteli / l <br /> __•_, Veh}clo certification <br /> lereby certity that the above named material wax pioked up I hereby certify that the above named material was delivered vAth- <br /> the generator sitelistedabove. out incident to tha destination listed below. <br /> W Gn"wm ow DA~sionat„n <br /> DE STINATION <br /> ne Name Phone No. �— <br /> ddress <br /> hereby Certify.that thv atnrre named material hoe boon aceoptod and to the ni my k go trio for�A LfLli�and act:urate. <br /> ime o1 AYtNor1zed A ant nate e a <br /> ter,. <br /> PASS COOS <br /> SF1200-r 20 <br /> DM <br /> TRANSPORTER RETAIN <br /> t`Od 'OH 9HOHd iJObJ <br />
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