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COMPLIANCE INFO_2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELEVENTH
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2200 - Hazardous Waste Program
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PR0513914
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COMPLIANCE INFO_2019
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Entry Properties
Last modified
11/19/2024 10:19:33 AM
Creation date
6/19/2020 10:46:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0513914
PE
2220
FACILITY_ID
FA0009583
FACILITY_NAME
CITY GARAGE
STREET_NUMBER
604
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23502301
CURRENT_STATUS
01
SITE_LOCATION
604 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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C— mo <br /> O N A <br /> =3o � � <br /> N <br /> v C:) rn <br /> a0at��N cfl <br /> P sv (D <br /> M g <br /> CD U) <br /> Fe- rwred OMB Na 2050-0039 O . <br /> u Please print a"(Form. for use on elite 112 rifer 1 <br /> l Oaneratorl0 Num6a+ �,PeaB I M 3Emro- 1: I Tr3cm69 umber <br /> 04 5 G5V <br /> (�,3 <br /> o` <br /> UNIFORM HAZARDOUS W <br /> WASTE MANIFEST GenaraNfs slm Address 11f d at d+an melling addrsasl <br /> i�eneraw�a Name aM MaIIN Address <br /> N <br /> O <br /> &,rWaWYS PhWC ar <br /> i U.S.EPA ID N�mher <br /> 6.Tre"P ftr 1 Compery Name rA <br /> I=EPR 10 Number <br /> 7 Trernpmkr 2 Comwv Name <br /> EPA i�NumCer CD <br /> Q.+ <br /> =-.Pealed Faolity Name and Sile Ajd5s y <br /> FaaA -s Phone' 10.Containers +.I Total 12.WO 13.Waste Cadea ay <br /> Nana,Hazard Class,ID Number. WtNO. iR <br /> 9b.U.5.DOT Desalpaon pntludiag Prolxr SN-0pi'4 No Type ab O <br /> and Pad.19 C>�{aqj <br /> anYl1 _ rlf rte-+ <br /> A <br /> Ofy CD <br /> 4 <br /> w 4 C7 <br /> 2 O <br /> i` <br /> O.. <br /> CD <br /> 14.Speoaf Handling tnWU;01;s and AtltliWIN irdamallon It <br /> 0. <br /> the proper shipping name.aId are classi5ed.Fes'--" <br /> l5. GENERA r condl4on for transport according 1e applicable Igntof onalaad national govemm <br /> }adons.It export shipment and 1 am <br /> FOR'SfOFFEROR'8 CERTIFIC0.TfON:Thereby declare that lee contents of this consignment are fully antl accurately dtional d a <br /> marked and 4beledrplacarded.and are in all Woeds in P!M� <br /> Exporter.I oorM plat the confentS of this consignment canFOT d the to ms ofrf lI amta large 9Pant ene�ralnr)ar(b) f amta small quantity gene �e Month Day <br /> ty 9 <br /> I rel that me waste milnmiza0on statement identified in 40 CFR 262.27(a)(� SignaNre � <br /> yprteldf5 PdntedlTyped Name n <br /> Fort 01 exll —� <br /> O <br /> 16.!nlemlaacnaf Shipments Import Id U.5- <br /> Export from U.S. Date I <br /> CD <br /> = re!fd exports only}: Day Year .�-F <br /> Transponef s Month N <br /> a7 TtansPorter pdro-{adgrrwt er Raoeipt of Materials Signature IQ <br /> Trarsp ter 1 PmtadfTyped NameYear O <br /> Monro Day � <br /> y Skgnature <br /> Y TranlilIM r2Prml Name �D. <br /> C ❑FukiRejection <br /> to y <br /> ❑Residue PerGaVRe;ecto <br /> 18a.D IC End cellon ce ❑Ouantiry ❑Type ❑ <br /> Manhet Referenda Number: US,EPAID hh <br /> 18b.A temate Fatality tar Genwama'1 <br /> T. O n <br /> VMonth Year O <br /> LL Fadfdys Poona: O" <br /> W 18c.Si ong dPJoarvw Fac+fity Or ferferahorj � � <br /> C = <br /> x Notice:State df California requ 5 <br /> w19 Hazardous Waste Report Management Metlwd Codes 00,.oodes far I azardoua waste treatment,diep3 al,and recycling systems} �T <br /> LU 1 2. generator to photocopy and mail to CD <br /> rs <br /> 0) DISC with 30 days: �, <br /> P.O Box 40fl C° <br /> 20,i]ennaled Facdiry O*nar a 07emmT:Certdica#on o1 race W of hazardws matedals covered by the man9taalure�4t es noted in Item 1 <br /> O Pdr*drryped Name Sacramento,CA 9S812- <br /> OWD A Form 8706.22(Rev.3.05) Previous edi0ons are obsolete. f <br />
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