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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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SJGOV\dsedra
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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 9: A designated facility signed copy of uniform manifest 016987902JJK (10/18/17) was not found on site. <br /> ryMn burmaW I] Ikr Y•n.m G1H•e.'�. — . <br /> w I,..r. ✓w <br /> YlmYne^� <br /> m Murmr <br /> 0 rSlfi 11 <br /> r+RL>•' <br /> _. ro.ensv,nars er,caul .x unn rs.+res.toes' <br /> un�Tn.ecroaar.l'nuwlm�+w.sniwlnP name.nmam cies:.,c e..,n. o„w,xr vnnnl <br /> rive <br /> 11` <br /> f 4 <br /> q cpe,�r,!Hs N,,g rnaauctiene a Addreoner Inloimalldn <br /> mint era NIIY and accurately deacrioea alwva by a+e P.P."hiPA"re namaazd are dassiFed,b"a e9� <br /> fh MERATOR'SMFFEROR'S CER71F1CATION:I harehy declare That th.mmm�ls at this canslgn kable international antl 1.00"19e'+e'nmerdal re9eltllons-Hexpert ehipmant and f am Ire Primary <br /> malRed antl IabeleNpiaraMed,and are in ell respects In proper eontlaion roc transport acwrdN9lo eppl <br /> Exporter lcafify that Me mntmts of this ponsi9nm-cnrdomnlodia terms M bra attached EPRAckv)rt Of4l Iamla sma114uantlH 90ne rY is gu6. Mn i� O� Year <br /> 1 alfy that rhe wait¢minimi]edon stslemanl idant✓fied in An CFR M.27W V I am a terse quantity + <br /> eignaNre ? (Ci �Jr 1 7 <br /> GerreretMSl�Merals Prin[eMyped Nsma / l - r' .-jr J�_ <br /> r-mlematianal'Shipmanrs ❑EXPod lmm U,S. Poll of enlryfaxll', <br /> ❑Impnrl N U.S. pale leaving US: <br /> rracapor<er signawre lrer0°tyl' Year <br /> W t7 rranaponerAckrowleCgmem of Receipl of M-1- Si alure 1 Moaih Day J'�+ <br /> Transporter 1 PrjpledR pad M gn i I Lam. I f J ` r <br /> [/l i rC lI iI Month Uay Year <br /> r 7 PnnledY7ypad Nagle <br /> SlgnaNra ;,w. <br /> 18,o xrapancy <br /> 18 �'t <br /> F <br /> J} 3.D.9mepancy lndkation Sp ❑ dua ❑Partial Rejacbon Iou11 Ralacfion <br /> J ace ❑4daniity Type Resi <br /> 1 Manifest Reference Number <br /> fBh.ANarrlate Facipty(or GanarxtorJ U.S-Ei'AIO tSumher <br /> U <br /> i iar,Fity's Phone- <br /> W re 18c signatuof Uemare Facility for Generator) Month Oay Year <br /> - a <br /> .9.Hazardous Waste Report Management Method Codes(%q_codes for hazardous waste treatment,dispcsaV,and reoyding systems) <br /> 2. 3. 4 <br /> 1 <br /> rX.Designated Facility Owner or Operator.Ce6 t sdun of receipt of hazardous materials covered by the mar lest except as noted in Item 18a f <br /> rinledI7yp Name sgnature <br /> EPA Form 8700.22(Rev.3.05)Previous editions are obsolete. GE <br /> John Alaniz, REHS Page 9 of 12 <br />
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