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COMPLIANCE INFO_2019
EnvironmentalHealth
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TILLIE LEWIS
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2200 - Hazardous Waste Program
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PR0514347
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COMPLIANCE INFO_2019
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Last modified
6/25/2020 12:57:09 PM
Creation date
6/25/2020 11:16:42 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0514347
PE
2220
FACILITY_ID
FA0010483
FACILITY_NAME
HIGHLAND WHOLESALE FOODS INC
STREET_NUMBER
1604
STREET_NAME
TILLIE LEWIS
STREET_TYPE
DR
City
STOCKTON
Zip
95206
APN
16336018
CURRENT_STATUS
01
SITE_LOCATION
1604 TILLIE LEWIS DR STE B
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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Ramos Environmental Services <br /> 1515 South River Rd. <br /> West Sacramento, CA 95691 <br /> (916) 371-5747 <br /> CAD044003556 Ce(09 <br /> SERVICE <br /> SERVICE ORDER ORDER IVO. 158589 <br /> BILL OF LADING <br /> DATE J _ _ JOB NUMBER <br /> GENERATOR ` � �IC✓ ' i �. .� �'�� �r1" -� G Q� a•` <br /> GENERATOR EPA# ���' �`� COZC%' � /ll�� <br /> BILLING ADDRESS <br /> � AMOUNT(IF ANY) <br /> GENERATOR CONTACT CHECK NUMBER �_t� i3` .� Ci tri) <br /> PHONEvl <br /> P.O. NUMBER <br /> JOB SITE ADDRESS �' ' _ CASH RECEIVED (amt.) <br /> HALIDES °= 7 t 9C, P.P.M. <br /> JOB DESCRIPTION --- <br /> , i S j1 <br /> MATERIALSs <br /> .� � <br /> )u�NON RCRA HAZARDOUS WASTE LIQUID, (USED OIL) CODE# START TIME�il <br /> ARRIVE TIME Z <br /> NON RCRA HAZARDOUS WASTE. SOLID - LIQUID CODE# I ' <br /> LEAVE JOB � � � S, <br /> FIU.S. DOT DESCRIPTION: p ' 1 <br /> STOP TIME <br /> (USED ANTI-FREEZE)NO-^N� RCRA HAZARDOUS WASTE LIQUID CODE# USED OIL FILTERS DRUMS <br /> MANIFEST NO. '1 `. `, 1 �' R v NO.OF GALLONS <br /> DRIVER'S SIGNATURES ' l `�-�"� ` `9.' � � r TRUCK# `} <br /> DESIGNATED TSDF: RAMOS ENVIRONMENTAL SERVICES. 1515 SOUTH RIVER RD. WEST SACRAMENTO 95691 CAD 044003556 <br /> I HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY OTHER WASTE,AND THE TOTAL HALIDES ARE LESS THAN 1000 RPM. <br /> This is to certify that the above named articles are properly classified, described, packaged, marked and are in proper condition for <br /> transportation, according to the applicable regulations of the Department of Transportation. <br /> Generator's Certification: I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined <br /> to be economically practicable. Ramos agrees with the generator to send all their hazardous waste to an authorized hazardous waste treatment facility <br /> via Ramos'standardized permitted storage facility. <br /> All used oil collected from the generator listed above will be transported only to a facility permitted by the State of California to accept used oil. <br /> Terms-net 15 days. <br /> After due date,,a,finance charge of 1.50% per month, 18.00%annual rate,will be charged on the unpaid balance.The customer agrees to pay reasonable <br /> costs and atto}iney fees incurred in the collection of this obligation.Venue for purposes of enforcement of this pbrligPition shall be Yolo County. <br /> I declare, under penalty of perjury that the foregoing is true and correct. <br /> X / \ <br /> k46��� <br /> GENERATOR SIGNATURE <br /> 24 Hour Emergency Response Team: 1 -800-456-7745 J5 3 1 1 4. <br />
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