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COMPLIANCE INFO_2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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DUCK CREEK
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2200 - Hazardous Waste Program
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PR0513919
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
5/15/2020 10:55:54 AM
Creation date
5/15/2020 10:27:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0513919
PE
2228
FACILITY_ID
FA0003758
FACILITY_NAME
RYDER TRUCK RENTAL #1071
STREET_NUMBER
3633
STREET_NAME
DUCK CREEK
STREET_TYPE
DR
City
STOCKTON
Zip
95215
APN
17331001
CURRENT_STATUS
01
SITE_LOCATION
3633 DUCK CREEK DR
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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3633 Duck Creek Drive PR0513919 <br /> February 13, 2020 Program: HW <br /> PHOTO 12: Manifest 006520392SKS found without a designated facility signed copy. <br /> tfi'Opl9 <br /> ( a N.• <br /> B.Uesr9 1�1 N tlSi- - <br /> C[,g'gN RpDR-- U.S.EPAID Number — <br /> '24-T 5 li TIgNWAV idFlUu. <br /> Facirirys Phone: ;3i`d3^i�3"�...-y.PS.�• St7MRAi..L :N U.S.EP�- <br /> 9a. 96'US <br /> U.S.p0T Descdptlon lu .Shipping—d Class,10 Number, _ <br /> HM and Packing Group(if any)) — <br /> � 1 —� 10.Containers <br /> 00 &REIENTHAlARDO[15 1ASTC N0' Pe Quantliyl z.unh <br /> RCF <br /> kND Q::L) 8[JLID;'•, INt.Na. te.waaa Clue, <br /> W 2' <br /> LD <br /> 14.SpecialHand ns <br /> and Additional <br /> -- <br /> 'ti kR FMER6ENCY �4T— PoJI <br /> 8 4E' ....1 ril (CH r s <br /> 15 G T •ele F RD e C R lin (here ytlecaethath•con entso m ced g' t re(lye d-cc ay ydeson ed above by the pro er h <br /> E Offeantllabeleattheconte is are nall respects grope c ndtonfor transport according to applicable imematio lad national governmental regulations.if export shipmentand lam the Primary <br /> Exporter,I cert fy that the contents of th s m s 9rnnent conform to the terms of Me attached EPAAcknowled p pp x9 namn ardare aaasifed packaged, <br /> I cert that the waste minimization statemen(identified in 49 CFR 262.27(a)(III am a large quart, 9ment of Consent. <br /> Generator's/ORerofS Printetl/rypetl Name r9 q tY generalor)or(b)(itlanasmall quantity generator)is mus. <br /> Signature <br /> .yl Mo N Day Year <br /> 76 ,ryonal Shipments <br /> Tran�pomarsignature for ex orW only): Pod <br /> to U.S. ❑Export from U.S. _ <br /> ( p y): Pod of entry/exit: <br /> 17.Transp)rterAcknowledgment of Receipt of Materials Data leaving U.S.: <br /> transporter 1 PrmledRyped Name <br /> Signature Month Day Year <br /> mosporter 2 Pnntedlyped Name IL..� �� <br /> I Signature Month pay Year <br /> 3.Discrepancy I� <br /> ;a.Discrepancy Indication Space Duanlil <br /> Y ❑Type ❑Residue ❑Partial Rejection ❑Full Rejection <br /> Alternate Facility(or Generator) Manifest Reference Number: <br /> 7s.EPAID Number <br /> 'ity's Phone: <br /> Signature o(Aftemale Facility(or Generator) <br /> Month Day Year <br /> ¢Mous V'-a.Report Management Mefhod Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> r'— <br /> ignored Facility Owner or Operator:Certificationof receipt of hazardous materialsials cuver�lnifest except as noted in Item 16a <br /> typedName <br /> Slgna(ure I Month I Day Year <br /> 00-22(Rev.3-05)Previous editions are obsolete. GENERATOR S INITIAL COPY." <br /> Lydia Baker, REHS Page 12 of 15 <br />
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