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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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TRACY
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3775
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3500 - Local Oversight Program
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PR0545738
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SITE INFORMATION AND CORRESPONDENCE
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Entry Properties
Last modified
6/8/2020 11:47:10 AM
Creation date
6/8/2020 11:41:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545738
PE
3528
FACILITY_ID
FA0003715
FACILITY_NAME
Tracy Blvd Chevron
STREET_NUMBER
3775
Direction
N
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
3775 N TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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Tags
EHD - Public
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( ) SN�nWuetions on bads ga b. Deportmad of Tesie seb.�.um Cm*W <br /> lkae PAs-ar typo hoer domed der eee a--Ale(1?piltirnrler. �.— Sacromrwro,Cailareia <br /> in <br /> shaclied areas <br /> HAZARDOUS1. Gimerwor's US EPA w W. ; Maafut Docv�ner�f lNo. 2. Pape 1 is no��!�by fed low.WASTE MANIFEST •// S Cy of <br /> ff <br /> 3. No and Moiling Addv �]TA g- 4J"¢ <br /> l'� vR 3�4 EJ.S j 3775 -T*Acl WL.vD <br /> A 'P c rr+ X51583 TfzAr:..�� R �3S3o� <br /> 4. G r 1�a Phan (-Sso) PAI• 0 <br /> S. Trwepsrw 1 Compmry Nems 6, US EPA ID Number <br /> –�' 7. Tramporler 2 Ca-spay Naar S. US EPA ID MUmbor <br /> U <br /> Zt. agrMFocivivfMarid Sale Address 10. US EPA ID Number <br /> 255 Parr BlVd. <br /> J? Ri'jw""'Ch. 94801 4 0 1914 6 6 3 9 2 #` <br /> 12. CorMainas 13. Told 1.1 UrM �� <br /> n 11.&W DOF prrer(plipa(leehudirq Puoper 51Nasis Ho=d Class,and ID Numbed No TvMVNt�ol <br /> 3 W 012te I:rq*y Storage Tank. - F;$CRC44 S j T F � F <br /> E <br /> N � <br /> E <br /> A <br /> T C. <br /> r O <br /> W <br /> (.J <br /> W <br /> N <br /> W <br /> Oc <br /> a f°, <br /> t <br /> Q 13. Spain!Marg hruvesar and Addllianl kFormallcm <br /> ►- V,-ep aur ., from sources of ignition. Always wear har�r at�s wl1 t wr�rki1>< it .3 <br /> z u.G,S.T. 'z 24 Hr. contact Nafm <br /> la aq l TCXM CMTWC&TKft I hereby doctors xre Vbv aanMMs of thk corstiprerrenl are fully and accurately described above by Proper shippig name and are classified, <br /> ` pad"meshed,and k6oled,and are m all respects in proper condition for tramport by highway owmdbp to applicable W40maknul and w"c'rnl povernmeM roprrlcol"' 1 <br /> IF I ant a lo"quadRlr 0issraNra aeeMflr*w Ibave a putlWcm id plate M tW%I t0e'WWW%4Msai Y of WON fwaraad to Are deEPepAAM44-iWN"M is <br /> ecornllicak Practicable a+d the I have soled I firs practicable meti od of hoah md,dorope,or disposal curuentiy available to me which minimizes the present and futon <br /> Nthreat to buMP r heelh and the s-virompmA;OR.0 t am a small qua-illy 9enerabr.I bare orad-0 pond faith effort to minimae my waste generation and select Ihs bast <br /> ��Name -a0, the Is oraiable to me and the I can afford. 1Month ow Year <br /> r / <br /> Gt4 'K�2� T,' <br /> tv 10 <br /> Z 17. TMWWW 1 of ME&A of MOW" ti Mme. <br /> G7 Year <br /> li a <br /> 0 1 T of Newo of Mahriak Month Day Year <br /> 1 Prbftd/vyad hie SipnaNn <br /> E <br /> e <br /> ` 19. Okenpency h>amlion ilpe" <br /> U p <br /> A <br /> Z C <br /> 1 <br /> har of o)hazardous nraariak Mris aaihp as noted to Ilam 19. <br /> T Puhded/Typed Na-e Sip-olure Mash Day Yaw <br /> Y <br /> DO NOT WRITE BEOW THIS UNE. <br /> Yellow: GENERATOR RETAINS <br /> DISC 8022A(1/9M <br /> EPA W0D---22 <br />
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