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COMPLIANCE INFO_2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4202
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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 8: A d nated facility signed co of uniform manifest 018248656JJK (2/22/201 was not found on site. <br /> 77,„ .. ... <br /> Y Is <br /> s <br /> J C U.{.E➢V.�D . <br /> drBro Mn'Vn e'O Fmper Sh4)Wq Nun..Nasud cion,Ip Numbr, t0-e Ines t <br /> Te, o ur <br /> t <br /> a <br /> I � <br /> tUrrAirg In3V+thna and Aatlltlorsl InbrmaflonI � <br /> 2�7 <br /> AWAF <br /> is, GENERATaR'aNFfEROR'3 CERTIFJ[AFIDN7 Ihem tleclare that Na rnnran fNis consignment are fully and acCvreselYdau bed ahe+e bl the Proper shYPP� M1 '��nd la wig <br /> marded antl labekNplaraNeQ and are in aN raepacla m p per eBeaalonfortran urt—rding toappt.asinlemaeonal and national govemnwntal reguVaGBns. Zig <br /> Exporterlcertay Nat the Mmssrls of Nis tansignmem oomorm to Netelms of sattachsd EPAAdm.srsumBMof Co,wsent. n narMis true, MmNI Day Yeas a <br /> I ce,Ify Nat the s'aste mini."ttn statement identified M40 GFR 25227( rff am a large gaantay Sign tor)or(by Ca!em a smell qua tm'ge � <br /> Generatoramaemfa PdntWyped Name Signa>ura - - --� <br /> 1 f6.Intematioeal Shipments - Ll6xpod from U.S. Part of aAbyfe.t: Z19 <br /> F ❑Impon to U.S. pate leaving LLS: <br /> = Transporter signature(for expode only): <br /> Ja-' 17.iransporterAdnowktl9menl of Receipt ofMaredals - Man74 Day Year <br /> TB Porter I Fnntedfryped Name - <br /> a Dal 'leas - <br /> QTmmperler 2 PMledlfyped Name ` Signature - <br /> 18.Dis'AAgncy {�Fu41 ReSeu�iat <br /> 7aa.Oisaepancy lndiubon Space Quantity Type ❑Residue Partial Rejection <br /> Manifest Reference Number. <br /> U.S.E'AID Number <br /> fSL+,Mems le Facility(or GeneratoY <br /> J <br /> U <br /> Farilitys Phone: Month Day Year <br /> 18c Signature of kemafe Fa.iq(or Gsneralor) <br /> Q <br /> 9.Hazardous Waste ReponManagement Method Was(i.e.,codes For Ilazardcus waste Geatment,disposal,and recyding systems) <br /> 1 2. <br /> 20.Designated Facility Owner or Operator:Cerliflrallon of receipt of hazardous materials covered by the manifest except as noted in Item 188 <br /> PrinfecPyped Name Signature Month Day Year <br /> EPR Form 8700-22{Rev.3.05)Previous editions are obso)ete. GENERATOR'S INITIAL COPY <br /> — — — — REV.4-17 Y <br /> John Alaniz, REHS Page 8 of 12 <br />
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