My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0008836
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
T
>
12 (STATE ROUTE 12)
>
13889
>
3500 - Local Oversight Program
>
PR0545719
>
ARCHIVED REPORTS_XR0008836
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/19/2024 3:45:50 PM
Creation date
6/3/2020 11:28:12 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008836
RECORD_ID
PR0545719
PE
3528
FACILITY_ID
FA0005335
FACILITY_NAME
CHARLES JACOBS
STREET_NUMBER
13889
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
13889 W HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
33
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
r ,r <br /> NON-HAZARDOUS Generators US EPA ID No Mand.., Z Page 1 <br /> WASTE M f xJA OD°da"Y"'�'°� oflow- 1-il <br />' 3 Generators Name and Mtailmg Address (AGE) SLABY SALES IiQC. <br /> P. 0. Box 903 1 �\ <br /> F3ORREGO SPRIrGS CA 92304 <br /> a Gwnerotnr s Phone{760% r 767-0776 I <br />' I S Transporter 1Company Name 6 US EPA ID Nurebar A Trarnporter's Phone <br /> Slaby Environmental NIA (888) 701-6600 <br /> 7 Trenspa seat 2 Company Name 8 US EPA ID Nurnber a Transporters Phone <br />' 9 Designated Fcalllty Name and Site Address 10 US EPA ID Number C focllys Phone <br /> I WESTERN ENVIRONMENTAL <br /> 62-150 GENE WBLMAS DRIN E <br /> MECCA GA 92254 C A R 0 0 0 1 5 7 2 0 5 (760) 396-•0222 <br />' 11 Waste Shipping Name end DeeenpTron 17 Conte nen 13 14 <br /> Tafrsl Unit <br /> No Type ouant Wt VO4 <br /> Non Hazzardoua Waste Soil <br />' 004D14 0 1989 P <br /> O b <br /> E <br /> 1 N <br /> 4 r c <br /> T <br /> 2 � <br /> 4lied <br /> D Addrional Dascnptarns for Material& luted Alone E Handing Cades ipr Wasies luted Above <br /> I <br /> I <br /> I <br /> 115 Sp►aal Handling Imirli- cions and Additional Informalion <br /> Site C TERKINUSMARKET (A.G.E.) <br /> 1 13889 W. HWY 12 <br />' LODI CA 95242 <br />' I16 GENERATOR'S CERTIFICATION I certlty the merencis desci{tec 000ve or +1 nonhv are a9lenr nal wbw +s raderol r. ulaFor reyerlinq pmper cilrpaml all 15esardoii WI L ade <br /> Primed/Typed Name Signoiu» M"th Cay Wear <br /> Deborah Slaby for AGE a 0 <br />' A 17 Transparser 1 Acknowkdpemer*of Recelpi of Mlaterlols <br /> A rinsed/Ted Noma w Mo Day Year <br /> o , <br /> p I i A franc arter 2 Ackno-qledgenirwrit of Racelpt of Matersa4s <br />' E�riedrTyped Nome 5rgnature Month Day rias <br /> 19 Dsscrapancy Inarcahon Space <br /> A <br /> c, <br /> I.I <br /> 2E7 Fanhiy Onne,or Ope nor Carnhcntion of ece pt of wosto materials covered by thls monifest except at noted in Barn 19 <br />' T <br /> YI <br /> Printed/Typed Name Sgnafure I Maar} pay Ywr <br /> i <br />' ORIGINAL-RETUF N TO GENERATOR <br /> T •d ;:Pncn4nfaanc T •'1u T 31.t 7 q"M I mq i SHW 7W T I WHL.S r G 500a Z C aaW <br />
The URL can be used to link to this page
Your browser does not support the video tag.