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COMPLIANCE INFO_2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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M
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MARCH
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1209
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2200 - Hazardous Waste Program
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PR0538317
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
5/28/2020 5:47:20 PM
Creation date
5/28/2020 5:45:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0538317
PE
2220
FACILITY_ID
FA0022071
FACILITY_NAME
Dollar Tree #05403
STREET_NUMBER
1209
Direction
E
STREET_NAME
MARCH
STREET_TYPE
Ln
City
Stockton
Zip
95210
CURRENT_STATUS
01
SITE_LOCATION
1209 E March Ln
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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EXHIBIT C. FACILITY MANIFEST 011410898FLE <br /> 111111111111111 <br /> Please Pdnl or -(Form designed for use on elite SI2-dlrhl wewnler-) Farm Approved.OMS No.2050-0039 <br /> UNIFORM HAZARDOUS t'Ge mwf IU N tuber 2.Page t d 3.Emergexy liesporvae Phone 4.Nrlihrt Trxknp Number <br /> WASTENIANIFEST CAL000391425 B775772669 011410898 FLE <br /> 5 Genaratota me w Ala.ngAMr Ganeramrs S to ASSMS(N dftnerrt man Mailing addra ) <br /> Dollar Tree #5403 Dollar Tree#05403 <br /> 1209 E March Lane 1209 E March Lane <br /> Geneatats Phone k C t ock t on CA 95210 <br /> ranaporiw .y Nwe U.S-EPAIDNumbw <br /> -324 <br /> ipialle c1panialtv Wast. Solutions <br /> . ransporler .5 EPA IG Monter 2 Cenp,ny Name ;, UQ <br /> ky��j rW �e ��r M/I 01,E <br /> 0N"ladFa0iiyr+0rneand;4reAddreas 21st Century EMN, LLC US EPA 10Numb& <br /> 2095 Newlands Dr. East <br /> Fernley, NV 89408 <br /> FaCi 1 P1108: <br /> so_ 9b.U.S.DOT Descipbw(ardudirg Proper Shipping Name,Hazard paw.ID N1rAler. 10.COMMners Ti.Total 12.,init 13.1Vasle Codes <br /> HM and Pa f g Gmep -4) No. Type Qtmnety 1A4ivol <br /> X UN1950, Waste Aerosols, fla2mable 2.1, ERG#126 I CF 00021 P 331 D001 <br /> LU <br /> lx X i1N1993, Waste Flammable liquids, n.o.s. 1, CF 00008 P 214 D001 D035 <br /> (Acetone, Methyl Ethyl Ketene), 3, PG II, <br /> ERG#129 <br /> X bN3264, Waste Corrosive liquid, acidic, 1 DF 00053 P 791 '1002 <br /> inorganic, n.o.s. (Hydrofluoric Acid, Acetic <br /> Arid) B PG lI ERG#154 <br /> 4 <br /> e.Special Handli7qInswRior,sand Additional lnrormadon 1.100843(Aerosols) 2.100850(F1aarahle Liquids) 3.1@0B42(Acidic <br /> Liquids, Corrosive) <br /> '5. GENERATOW&OFFEROR'S CERTIFICATION:I heretry declare VW Te mm"at his cansigme»t are h*am emxafey described above by Ire Proper shippng name,arta are 0wifled.packaged, <br /> marked and mbeled Vacarded,and are m all respear in proper oondihcn for trwr 1po'I acmrd'rg toappkabie elpmaAorMe and national govCwirneMel.egAaniom N export shpmem am I am tka Primay <br /> Exporter.I Canby Fal HR donlaros of'hn5 comsg wwl cordam to the terms of the attec od EPA AckreT.kd enl of Comm. <br /> Cerafy Bre)fe wa3le mfrarnmobw slap r ldenti:�ed in 40 CFR 26227(a)Ir I am a targe(?Lw*generamr)a(b)(g I wn a Smell puantty ganeratar;o true. <br /> a n r;y re ear <br /> .._..y a, ':=- -'�\L, �3 ' — 11 0312@1f <br /> 16 1memalknal5hpnr cis <br /> ❑Ivpod p U.S ❑Expanfrom U S Port of enhyleziL <br /> Tr rte sul=m(for eXPDrlg Ogle Wwg U.S.: <br /> d' ?-Transpw&Adao Ae"fo of Ftewipl o!Mawlals <br /> -M )w Y <br /> John Lain 11 03 201 <br /> x Transputar 2 PdnredTyped Name s9nattft V MDV Llay year <br /> •5 Diwropanty <br /> lea 'a ❑Q.-tily ❑Type ❑Residue r�Penal Rejedlone,ec <br /> ❑FLAIR Oee <br /> Manifest ROareocn Number. <br /> Mo-Ad:emate Fadlby(a Gereram•) U.S.EPA 1D Hinter <br /> y <br /> C <br /> � Fad' s Phare <br /> W Ift,S rgture of Ah v,0 Fa$q{or Generator) Mor1h Day Year <br /> H19-Hwardous Vhste Ftepat Man I IA01hod Codes els.,codes la hares IUM waste 1.11 115",ad req"sy9le.rrs} <br /> C 1. 2. 3. a. <br /> -/ H-1 2- <br /> 20.Dr gwled c hey Owrw or Operator-C lkabw dr receipt of hazardous maWials mvered by the mmrfest axwo as noted in Item 16a <br /> rirdedfipped Name ' L4D.* Day year <br /> EPA Form 87pp 22{Rev-3 05 P ivima ed tions are Obsolete. DESIGN. E0 FACILITY TO DWI NATION STATE IF REQUIRED <br /> B700-2212Y3 CAL8470018 540030301 041239726 M PD11031B SDII0318 <br /> April 14,2020 pg-5 <br />
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