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COMPLIANCE INFO_2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2200 - Hazardous Waste Program
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PR0538513
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COMPLIANCE INFO_2019
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Entry Properties
Last modified
7/23/2020 1:41:30 PM
Creation date
7/23/2020 1:12:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0538513
PE
2220
FACILITY_ID
FA0016414
FACILITY_NAME
OLDCASTLE APG
STREET_NUMBER
4202
STREET_NAME
GIBRALTAR
STREET_TYPE
CT
City
STOCKTON
Zip
95206
APN
17728043
CURRENT_STATUS
01
SITE_LOCATION
4202 GIBRALTAR CT
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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4202 Gibraltar Ct, Stockton Record ID PR0538513 <br /> 11/13/2019 Hazardous Waste <br /> Photo 4: A designated facility signed co of uniform manifest 019676593JJK 7/10/2019)was not found on site. <br /> K� <br /> d3K <br /> - <br /> wowear -, . o-�"nWres�w.oarm.Iadtl.reMtlr+^r��i.mw �r <br /> Ga' <br /> Y <br /> u•a�� <br /> 1 <br /> f to Grnlniners 11 iauf 1'L.Jnn 53 Wdsia CuS<; <br /> _ r'uby PruS"rSF.igFnn9 N:inu•.Ha:a.rl G�,a�Lfi�.i���_�__ QeantilY WWF <br /> No TYPa <br /> as <br /> 4 F S <br /> z <br /> w <br /> a <br /> ru sp_�ci.ti RandFl�IrslNctiMsdnd AtlditlMal lnfom+a4on ,r <br /> !flVES <br /> pin <br /> 13 OENFRATOR'SrOFFEROR'S CERTIFICATION:I hereby declare Kral the mnlente oftlds�n'anmem arch luuAn�mationalaad nafionagp lnenla5l¢gala ons it xpud sNpm nlrand I a-v.P r d, <br /> rrvxrraa and ubdkafylawMed.and are in all respecU in proper—isari for k—pok aFporaing k app ira <br /> E.podar,I rertity Thal Ue mnlenis of Uis consignmePi cnnlorm IP are Eemrs Prue atleched EPAgoFauwledgment of Consent. neravoO is true. 4 <br /> i nero'ty uretlhe wazle minimuatlort slaramenlV.i,ified in 40 LFR 292.27(a)(ir I am a large gpamny generator)o[(b){ffl amasmall quand ge Mmlttr Oay Year <br /> Gerrsralm's/OMe�PnnledTyped Name Slgeatan` II <br /> t 1� <br /> ISJn*emaaonarsm Is [Impodm us ❑Export from D.S. Pod of entryledll <br /> Z Transporter signaNre(forexporffi only): 9alp leaving D$' <br /> T7.Tran9porter AcknmvkdgmenI of RecevtofhtareUa µonttl Da YCar <br /> TIM-", i fl!dayT�o�d Mame sgnatu _ Y <br /> p - - <br /> a <br /> Transpode12Prinr0Typed Name Signi ""nth Day Year <br /> 1_ <br /> 1A-Dlacmpancy <br /> 18x.Disuepancy Irldca0an space ❑Full ite}ecti0n <br /> ❑Quanfdy ❑7ype LI Residue ❑Par4al 4tejection <br /> Mandest Reference Ni <br /> I&?Ilemate Facility for Genaralw) 6 S,EPA ID Number <br /> 1 <br /> U <br /> Phone <br /> F7Sc: 'oalure ofAllemate Facility(or Generator) Month Day Year <br /> - - Nous Waste Report Management Memcd Codes(,e.,codes for hazardous waste"anent,disposal,and recycling Spli <br /> z' 7. 4. <br /> 10 Designated F804 Oweror Operator:C,,fodon of receipt ofhaz'ardousmatenals covered by the manifest except as nded in Ilem taa <br /> Prinied?ypedName 5ignaNre Month day Year <br /> 870(7-22{Rev.12-17)Previous eic Ops are obsolete. <br /> GENERATOR'S tN1T1AL COPY <br /> John Alaniz, REHS Page 4 of 12 <br />
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