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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1721
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2200 - Hazardous Waste Program
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PR0518706
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
4/15/2020 11:51:40 AM
Creation date
4/15/2020 11:26:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0518706
PE
2220
FACILITY_ID
FA0000591
FACILITY_NAME
QUIK STOP MARKET #2152
STREET_NUMBER
1721
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
APN
062-060-48
CURRENT_STATUS
01
SITE_LOCATION
1721 S CHEROKEE LN # 1
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\dsedra
标签
EHD - Public
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-X.- Wim• ✓ �_. __.� _ <br /> ert� (Form designed for use on effte 12-pfirh). carte(.) Form Ap OMB No.2050 0038 <br /> UNIFORM HAZARDC)US 1'�eretor f6 Number 2.Pepe 1 d 3:Emergency Response Phone 4.Manliest Tracidng Ndmlow <br /> WASTE MANIFEST f '�^1,+ Z S-A�i':Ll/ '7 �J K <br /> 5 Name.W MaWrQ Address moose i'Smc tRa aen .rro gr ditvnt than maim address) <br /> '.�r���7{[[[ a �vy�+( ^�,,A <br /> l� rf�:D;'4. u 4,rG.tC,'iN La1:t? .�,.: ".'.SH:- ..+..�3.'1`di'.•)i. �.T_ '�' LS. <br /> 8.Transporter 1 party ;r -_27) <br /> rc t `•i 2 <br /> Et. .R�j,'7a9•" GCrttS1?;� n� .��: 'J e1' "r•1 r dy 1R '1 +. - ' '�••,• . <br /> I.Tranepertar 2 Complay Name: U.S_EPAJD <br /> Ntifftor— <br /> S.Designated F,a7dW Name and Site AdMess U.S.EPA ID Number - - <br /> =r <br /> nodi s <br /> .y r `' y _ iGs1Yt'w� 2 aq'twx? w oq=n�. tzi�5 i t er fi I r s: a `�kr"a <br /> 9a. 9b: OOTDeeproon(k"'Proper ShlppvD:Name ¢f C {lulnpeG*^t3 }^n�<__:.a m r tO:Gatr�grerah r�{ii1 Zofel r: 1T�link .i ne l3 te'Codes <br /> HM aril PackN C—v V wy)).r: No. Type puan8(y W17Vol: <br /> 1: dd .fix o � i�S(�y'�(•t�i3�j d �ij�':ei• Z::v;S"tF "a9:A?�n JP C�rlre-fir&T�y>iJ'1�1- <br /> Fact <br /> M :G"9�u{S�tl..tling�r111. 3E�:l.,f_ d.M,W tG�2.3. rae itrP!vper wrrd8artam nashrrai cori(amdo:t#re b�tti3rof tlie�ladied-PdnWypedName #brig :Day' ear <br /> O ^PatT—Sporterefforts ory) DateO Transporter) Afenth Day. YearT 2Prided(Typed Name l Sigrw9 j� 'huhI as.Dlvcrepanry Indication SpaceQuanw- Pipe 0 Residue Part al R"Oon FuA ReJectlonMaaha Reference Number:18b.Alterrute Faculty(or Generator) U.S.EPA ID Number-1Fadfty'e Phone,-. Day Yearw19.Hezar"M Waste Report Menagemerd Method Codes(.e.,codesfar hazardous waste traatmen4 disposal,and rarydrg systarre)20.Desgna:ed ily Owner or Operator.Certlficatfon d receipt of hau"or s rrate0ale covered by the marifast&cept as nded in item 18a <br /> PrinudlT Name .� �..swansa" � � MaQr iYMr, <br /> EPA Fain a70 (Rev. •05):Prev ous editionare ob a e. TRANSPORTER'S-cep, — <br />
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