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COMPLIANCE INFO_2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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CORRAL HOLLOW
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15999
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2200 - Hazardous Waste Program
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PR0514115
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
6/24/2026 11:12:44 PM
Creation date
5/18/2020 3:06:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0514115
PE
2249 - RCRA GEN 50<250 TONS
FACILITY_ID
FA0003934
FACILITY_NAME
LAWRENCE LIVERMORE NATIONAL LAB - SITE 300
STREET_NUMBER
15999
Direction
W
STREET_NAME
CORRAL HOLLOW
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\kblackwell
Supplemental fields
Site Address
15999 W CORRAL HOLLOW RD TRACY 95376
Tags
EHD - Public
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E <br /> I IJ, 1� <br /> Please onnt or�Pe (Form des rued for use on shle(12-pitch)lypemlar.) FormA <br /> IpMyed.OMB Na,2A51kOD39 <br /> UNIFORM HA7ARLIOU5 I t GerlereWI ID Number 2+'ape 1 of 3.Emergency Rosaorae Plane a.Nrm ro &ft Nwasller <br /> WASTE MANIFEST CA2890090002 1 925-11-3-F2Q500587 Q JA <br /> 5 Genera or s Nar�and Map tg AQQress Generaars Sde Address(d dHrerenl thaw miahV addressp <br /> Laurr"_ ce rermerY P�lat,�wa La craeary Sto 30I fc• "+IISA lax,x^.tx Lsverrcre rjatona3 Laburawv S-te 300 (cr r4r3SA <br /> F 0. E_x Rpa ;L.7a6 L'.errcre rC"• ?.4551 v-a: F(a,err Raab Tarr CA 35AYF <br /> Generators Pfmne 9:5-a12-19-15 A7 4 SL lv;rg <br /> 6.TransporW 1 Company Name U.S.EPA ID Number <br /> Clean Harbors Environmental Services Inc. MAD0393221-7% <br /> 7 Tramsponer 2 Cartwry Nvm u s M-ID-Number <br /> B.Designated Fac0i Nan*and Sae Address US EPA ID Number <br /> Crean Esaroors 8ult`Ewrl err. LLC :=A u9$66p5 �� <br /> 253; West L:ter, Feed id'attcnA 'we CA 33:0, <br /> Facts,s Phone 5E1-?5:-620C <br /> ga 9b U S-DOT Desarpbcn(mcludinp Proper ShgWV Name Hazard pass,fD Number I Containers <br /> 1 s.Total 12,Urri <br /> Hkt and Pacririg Group M any)) Na Type Quanaty 1Mt Ab 13.Waste Codes <br /> 1 RCL NA2212.Ai bestos ? III [ERG 1711 IDUP022 0-11 <br /> a <br /> a 151 <br /> w <br /> x 2 <br /> w <br /> c7 <br /> 3 <br /> 14?,per,al Handtrng Instruct cos and Aiddowil Btb lion <br /> Eroergenclr Reipense Mine a 3-4M5 Contact narre LLNL Ernef2eftL r Ekspatch. Load No ETW 19-04.Ship Doc No 5-237024. <br /> REreraenC3 rdErasenurYberff4, 11 <br /> n in-voice.QM30C=-. EIn nurdefCVhF2-9.s i. :r]vARCG-43X,Er,:�ri;ewar- <br /> rvlocleLto-Ca 95356 !80-53 fl <br /> 15 GENERATOR'Sioff EROR'S CERTIFICATION:I N&W"dare Ihat trtie oarslerts of the or ns"ril are Ui aid acaM*desarbW above by the proper sNMng mama,and are dassrlied,paMaged <br /> marked and LVwW4WCarded and are in a)respacls rn preper cwd*m for harrspmt acCp"to a.pVkable nramationaf and naborW omrgi*rrtal r-u s.If export shprtrml aid I a�-the Primary <br /> Eaparter,i sertdy aa1 Vie r-.fonts d the consigrnmaml writcrm fq d10 terms dthe attadied EFx Ad�cvAedgmesit of Consent <br /> :certty that the waste muLm¢at==!emient OeWed in 40 CFR 262 27(a)(d i am a forge GraMtt gcrierator)or(b}(if I am a smelt m tetra. <br /> GeneratorsClferors Prmsed iypcd Name Signature mom Day 3;—W <br /> Scott A Drat arr t+r bed.f: n' NNSA <br /> F16 IntBmatorW Spi;imants rriport U S <br /> y I ❑Eipert tram U S Pon dernry-slut: <br /> Twisoa7er signature(tar exports c*- Dale feavetp U S <br /> 17 Tra:.9porter kAnoMadpwrl of Recept Of klatersals <br /> OTray- 1 P Wired Typed Name u)naturo Month ay Year <br /> a 1 <br /> QTransporter 2 nntedlTyped f Iame Srgrtature morn pat, Yew <br /> to Dwepa%y <br /> 12a DrscreFarcy Ind=36on Space ❑Quanl ry ❑Type ❑Residue Farhat Refecaon ❑Fut Roo. <br /> k[anArx Itch Ahernale Fawy jar Generator) Rasercrlrn Nun-barU S EPA ID Numaer <br /> U <br /> LL Facky s 4li ore <br /> 18c.Signature of Attemale Facdsty for Geretaw, Month Da-r Year <br /> w19 Hazard_us Waste Report klariagemerit Method Codes(.e..codes for hazaftis waste treahmeril.disposal and recyting systems) <br /> LU t 2 T <br /> — <br /> rSW ynated Facility Comer or Operator CBru tmna'i d recewt of hazardous materials covered=9 flip mianfest excolx 0 n B <br /> Avea; Signature k <br /> Ll <br /> EPA PTyf 417 •22;Rev 3.051 Previous ed-5ons are obsolete IGFIATED ACILITY TO STI AT10iV STATE(IF REQUIRED) <br />
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