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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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2800 - Aboveground Petroleum Storage Program
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PR0516229
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
4/14/2020 4:42:53 PM
Creation date
4/14/2020 1:45:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2800 - Aboveground Petroleum Storage Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0516229
PE
2227
FACILITY_ID
FA0012386
FACILITY_NAME
BRANNON TIRE - CLAREMONT
STREET_NUMBER
4905
STREET_NAME
CLAREMONT
City
STOCKTON
Zip
95207
APN
10223010
CURRENT_STATUS
01
SITE_LOCATION
4905 CLAREMONT
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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FRE-NIOU TE -VIRONMENTAL S#RVICES, INC. <br /> pend Pj%mcnt r.,: PSene: EPA ID=CAROM!-;101- <br /> P.O. Buy Son: OQ C.S.D.O.T = 1484661 INVOICE # <br /> aca\illi. C a 44646-251` Fzx n- 18 :099 D.T.S.C.=3i44 <br /> «A A. a Wa`TCrer,_o-,al.corr. CA#274461 Date L- 702 24K 1 1 <br /> 51;TE AraRESS BILLING/MAILING ADDRESS <br /> Customer Brannon Customer Brannon Tire <br /> 4905 Claremo t Avenue P.O. Box 1988 <br /> Stockton, CA 9 207 Stockton, CA 95201 <br /> E.P.A. t CAL 000196 538 Phone <br /> Additional Contacts: 209 77-9000 <br /> ke <br /> PRODUCT - ERVICE INFORMATION PROPER SHIPPING DESCRIPTION <br /> • 7,4 • 21 . 30 - 45 - 60 - 90 . 180 • 365 W:C WASTE I MANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT <br /> CODE <br /> Non-RCRA Hazardous Waste Uqui (Used Oil) CA 221 <br /> 1.3 <br /> Non-RCRA Hazardous Waste Liqui (Used Anti-Freeze) 1 CA 134 1 Gaorls 100 g <br /> Nor?-RCRA Hazardous Waste Uqui (Oity Water) ! CA 223 j Gakm <br /> Drained Used 09 /Gasoline/ Fitters N/A 55.00 <br /> Norl`RCRA Hazardous Waste Soil(01 1 ded Debris, Sol) I CA 723 <br /> Flarts Washer Servioe CA 223 <br /> on Hazardous ante quid(Brake Ruid) CA 343 <br /> Waste FWmmabie LiglLad, l O.S, 3, UN199. PGII(Gasoine-Diesel) 110018 <br /> f <br /> ce = :Re-cve A' •A2 5g g ❑ 15g 7 30g S P F <br /> -�c' 4YC-es C "es' c5s Fo" Z) Generator Knowledge 52' PPM 200 <br /> ces1ACC'ic-c' ick?:e/Additions: Labor/ LAB Packing/Site Cleaning <br /> Clecn.: Y I_cbels j Oa G-2 13- 11 A/F UOP y Oily Debris i <br /> /Z o it 2 <br /> SERVICES REQUESTED BY I TAX <br /> '-ve <br /> Acce 1 X W__ " = P- O. # TOTAL CHARGES: <br /> GENERATORS CERT FICA'lOti: _ =_ - _- •-_ :_ _ _ _ -`_ _ _- __ `_,e o`,o,o�r slriocing home and are classified•packed•marked,and <br /> - _ = _ _ _== - - === _ -= �e,-e^"regu!a;ens. I am o large quantity generator,I certify that 1 <br /> ec -^_e econen-.Icc11v crec-ccble and that have selected the practicable method <br /> _- - <br /> ---c^^ec" rd',e e, oc,ne,f,CR.if I am o smol quantity generator,I have made <br /> c,c ca e-o-e a^c me':cc^e%`ora. All used oil from the generator listed above <br /> ____ _ _ - :_ __ _ _ _----_----- :c•-s_c aR c - v -a a-ec.;•ec to comply with Federal regulations applicable to'he <br /> __ -- - --- == -e"=sc!osec. -"e C.5'amer agrees to Pay reasonable costs and attorney <br /> - - c =_ '== _= cec ore,;^.der eenc.,y c'veru that the for oin is true and correct. <br /> DISP SAL/RECYCLING =ACL! (lection Station Industrial- Agriculture Govemment Marine Other !ndussMoI LubOlating <br /> Eeryaen Oil In: evs-DI E w7w Oi,Inc [ ]Clear,Harbors San lose LLC <br /> 44g1 Road 306 [ I Big Sk Em9wmertel [ t Cleanvsler Efm mmerta I l <br /> 1 met Ave. 1021 Berryem Road 401 W.Channel Road 2430 Almond Drive <br /> Dana 956'E 2 GA 94560 3 Sen Jose,CA 95133 4 Benicia,CA 94510 5 Sihw Springs,CA 89429 <br /> 51a CAD%24468-74 510 CAD 58088741 401 CAD 059494310 510-541-2128 CAL 000301639 775 577 9001 NAD 982a8483 <br /> Print Na o s Signal <br /> I <br /> herreby certify that 1 hav rea a _ authori to bind rhe above liste enemtor e t rm ne rever a side f this for <br /> m. <br /> 990/99l DNI SOAS ANH MaONHHA 666£RVVLOLT YVA Z£:9T TTOZ/ZZ/80 <br />
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