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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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2200 - Hazardous Waste Program
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PR0530695
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COMPLIANCE INFO_PRE 2019
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Last modified
4/29/2020 3:01:12 PM
Creation date
4/29/2020 2:47:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0530695
PE
2220
FACILITY_ID
FA0003848
FACILITY_NAME
Verizon Business: KINGCA
STREET_NUMBER
13850
Direction
N
STREET_NAME
DE VRIES
STREET_TYPE
RD
City
LODI
Zip
95240
APN
05524018
CURRENT_STATUS
01
SITE_LOCATION
13850 N DE VRIES RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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Site Address: i3giO North Dowries Road <br /> Lodi,CA 96242 <br /> 9C PPW 3/3M ORDER NO. o-274 002_ <br /> DOCUMENT N0, 480167 STRAIGHT BILL OF LADING <br /> TRANSPORTER11 VEHICLE ID# <br /> EPA ID# TRANS. 1 PHONE(/gj4 792.5000 <br /> TRANSPORTER 2 �c�S V �' VEHICLE ID# <br /> EPA ID# TRANS.2 PHONE <br /> DESIGNATED FACILITY SHIPPER ATTN3ac h Feindoid <br /> Clew Harbors San Jose LLC MCI <br /> FACILITY.EPA ID_# . __. SHIPPEREPAID# <br /> CAD06949431 ' CAL000347339 <br /> ADDRESS ADDRESS <br /> 1021 Berryessa Road PO Box 726 <br /> CITY STATE ZIP CITY STATE ����pp <br /> San lose CA 98133 Chino CA 91706 <br /> CONTAINERSTOTAL LUNIT <br /> NO. & SIZE TYPE HM DESCRIPTION OF MATERIALS QUANTITY WT/VOL <br /> Amon EMInROIeIMEOUALLY HAZARDM SUNTAMCEs,sous, J <br /> N y x u a:. as eu nr4Rse� <br /> B. <br /> C. <br /> D. <br /> E. <br /> F. <br /> D. <br /> H. <br /> SPECIAL HANDLING INS RUCTIONS MR4EMCYPH0K&t(soo)4*"719 SEMERATOR:OIICI <br /> CH59734SERW 171 <br /> SHIPPERS CERTIFICATION:This Is to certify that the above named materials are properly classifled, <br /> described, packaged, marked and labeled and are in proper conditiop for transportation according to <br /> the applicable re ulations of the Department of Transportation. <br /> PRI .,JJ /f SI DATE <br /> SHIPPER <br /> PRINI SIGN DATE _/ <br /> TRANSPORTERI <br /> IN IQN !%E 'TRANSPORTER 2 -� �y l� <br /> PRINT SIGN DATE <br /> RECEIVED BY <br /> CHI 107 <br />
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