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COMPLIANCE INFO_1999
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231898
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COMPLIANCE INFO_1999
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Entry Properties
Last modified
6/9/2020 8:21:13 PM
Creation date
6/3/2020 9:43:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
1999
RECORD_ID
PR0231898
PE
2332
FACILITY_ID
FA0003966
FACILITY_NAME
SHARPE SITE/DEF LOG AGENCY
STREET_NUMBER
850
Direction
E
STREET_NAME
ROTH
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19802001
CURRENT_STATUS
02
SITE_LOCATION
850 E ROTH RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\UST\UST_2332_PR0231898_850 E ROTH_1999.tif
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EHD - Public
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Page 1 of d <br /> MCKSON Tank Processing JOB S06 <br /> TANK CERTIFICATION <br /> #*********************** PART 1 -To be completed bythe Customer <br /> ************************* <br /> ��►SZa,(tc,..7coa <br /> :USTOMER: 1p ( /'�CJ GENERATOR: S Sl'?1'� State Waste Codes: -� <br /> .00ATION, /9 r—,0L.,Ar my Lext EPA I.D.f1: 2 oZ EPA Waste Codes: <br /> 1/5 W1,00 -0/ - 0.5 -63-611-.©S None <br /> 'RANSPORTER: —F jZ I QEnJT MANIFEST It: ❑ See Attached <br /> TANK 1 TANK 2 T 3 TANK 5 ��y K 6 <br /> Sri 1p� �g�Xff <br /> l� �(� <br /> TANK{t: S -Z <br /> CAPACITY: o?c) oDo oW,Ooo 0 wv X24) ovd /.7,060 /22LO D 6 <br /> DIAMETER: _/2..5'—/ 10. S <br /> LENGTH: 3�, 32, _3A I — <br /> STEELIGLASS: -� —.1; -S <br /> LAST CONTAINED: ruC� 4 <br /> , U — — <br /> LG = Leaded Gas, UG = Unleaded Gas, D = DieselO = Used Oil, FO = Fuel Oil <br /> Specify the material Last Contained if other than above. <br /> ERICKSON, INC. TANK PROCESSING FACILITY <br /> LAND DISPOSAL RESTRICTION NOTIFICATION FORM <br /> Amok <br /> caste represented on this manifest is not generated by a chemical manufacturing plant, coke-by-product recovery plant of <br /> ,etroleum refinery. As such, it is not regulated under 40 CFR Part 61, Subpart FF(NESHAPS for Benzene Operations)_ <br /> Pursuant to 40 CFR 268.7 I am notifying Erickson. Inc. that the material described by the above manifest is a nonwastewater, <br /> ton-BCRA hazardous waste and not currently subject to EPA Land Disposal Restrictions_ <br /> V, Pursuant to CCR 22 66268.7 I am notifying Erickson, Inc. that the material described by the manifest is a metal containing <br /> don-RCRA solid hazardous waste(66268.29(g)),and an organics containing Non-RCRA solid hazardous waste(66268.29(k)). The <br /> reatment standards for these wastes have been repealed_ This waste is no longer subject to land disposal restrictions. <br /> am an authorized agent/representative of the generator_ I certify that all information submitted in ,his and associated documents <br /> s complete and accurate to the best of my knowledge. The tanks on the transport equipment have been numbered to correspond with <br /> he information provided above. In the event that the tanks do not correspond to the form, I will pay any and all costs incurred in <br /> -edifying the discrepanry(ies) between the tank(s) and the form. In the event that the tank(s)contain excessive solids or liquids, I <br /> agree to pay the cost of preparation, transportation and disposal/recycling of the excess material according to the schedule of charges <br /> n effect at the time of receipt of the tank(s). Further,I will not hold Erickson,Inc. responsible for any damage to tanks which occurs <br /> after the tanks are removed from the ground_ <br /> AUTHORIZED REPRESENTATIVE <br /> SIGNATURE: S'c T �� DATE: <br /> ?RINT NAME:_ _.�E'/��=4�`'' C�E'EigGx� TITLE: E.cl;.� .✓/� �7'^L <br /> Ac r <br /> For assistance in completing this form, please contact Karen Ruffin at (510) 970-7463. <br /> ONSITE TIME TRUCK 1 TO <br /> TRUCK 2 TO <br />
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