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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 I of 1 <br /> ERICKSON Tank Processing JOB <br /> TANK.CERTIFICATION <br /> PART I -To be•completed by the Costoer <br /> 7 5r2 <br /> CUSTOMER: .�-• n ,: _/� GENERATOR- L !}C.C� State Waste Coles: <br /> LOCA-n0N:_ —4j-C _ EPA Q2�Z.i EPA Write Codes: <br /> None <br /> TRANSPORTER: � Ger— MANIFEST#: z � Z D Sec Attached <br /> TANK I TANK 2 TANK 3 TANK 4 TANK S TANK 6 <br /> 2S a, <br /> TANK#_ ----- <br /> CAPAC rj -- <br /> DIAMETER_ - --- <br /> LENGTH: <br /> STEEUGLASS: fr <br /> LAST CONTAINED: ((�_ <br /> LG = Leaded Gas, UG = Unleaded Gas, D = Diesel, UO = Used Oil, FO = Fuel Oil <br /> Specify the material Last Contained if other than abovc- <br /> ERICKSON. INC_ T.ANK PROCESSING FACILITY <br /> LAND DISPOSAL RESTRICTION NOTIFICATION FORM, <br /> e waste reprc--=tod oa this manifest is not gc:cated by a c ne;nical m,^uf ct:rng plant, coke-by-product recovery pIazt of <br /> pdr.61=m rc!jnc_-y. A;such, it is not regulated under 40 CFR Part 61.Subpart FF(NEST APS for Ec^_=c Op_-_dons)_ <br /> Pursuant to 40 CFR 268-7 I am notifying Erickson, Ing that the material described.by the above manifest is a nonwastewater, <br /> Non-8CR4 hazardous waste and not-currently subject to EPA Lead_Disposal Restrictions. <br /> Pursuant to CCR 22 66268-7-1 am notifying Erickson. Inc- that the material described by the manifest is a metal containing <br /> Non-RCRA Tad hazardous waste(66268.29(g)),.and an organics containing Nan-RCRA solid hazardous waste(66268_29(k)). The <br /> treat:ncat stan4ards for thcac vrsics have bear repealed. This waste is no longer subject to Iand di.,;posai restrictions. <br /> I am an authorized agentfrcpccscntative of the gencrator- I ratify that 211 information submitted is this and associatcd documents <br /> is complete and accurate to the best of my knowledge_ The tanks on the transport cquipmctc have be a'numbered to correspond;w(a <br /> the inforuatioa provided above. In the evert that the tanks do not correspond to the forst, I will pay any andall,costs incurred in <br /> x- fri.ta Lh d �z^.�� r.)'oder= Leto txrzkZs)and the fors in the cv,=-t that LLL t� :(s)cz-vtaiu cxcc=s V... Rids of Iiousds, I. <br /> agree to pay tate cost o p-t�ration,trzri,-Poetatien a.td disco sdUrerycii^_g of the c=:�=trata:al according to th•.c uSaiule of cn;lrg- <br /> in effect at the tirne of receipt of the tan;c(s). Further, I will-not hold Ericksoa,InL rcsponsibie for any damage to tanks which occurs <br /> after the tanks a:z removed from the ground- <br /> AUTHORIZED"REPRESENTATIvC <br /> SIGNATURE- DATL: <br /> PRINT NAME: �� « ��e OIZ51 TITLE: <br /> For aVsisunce in completing this form, please contact Karen Ruffin at (510)970-7463_ <br />
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