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2231-2238 – Tiered Permitting Program
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PR0507095
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COMPLIANCE INFO
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Entry Properties
Last modified
8/17/2020 12:31:27 PM
Creation date
7/30/2020 7:43:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2231-2238 – Tiered Permitting Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0507095
PE
2231
FACILITY_ID
FA0007707
FACILITY_NAME
SAN JOAQUIN REGIONAL CONSERVATION CORPS
STREET_NUMBER
4421
STREET_NAME
GIANNECCHINI
STREET_TYPE
LN
City
STOCKTON
Zip
95206
APN
17924017
CURRENT_STATUS
02
SITE_LOCATION
4421 GIANNECCHINI LN
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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SJGOV\gmartinez
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FilePath
\MIGRATIONS\Tiered Permitting\G\GIANNECCHINI\4421\PR0507095\COMPLIANCE INFO.PDF
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EHD - Public
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1C r <br /> v/ Smhe of CaObmio--Erwimemern Prosthion Agency <br /> Form Appfuvell 9MB No. 3 9(Eaplros 930-96) See Instructions on.back• age 6. Deportmentne Teak Subna«n Central <br /> l2 prim or type. Fo der' d for use on elite(12pf of,pewmvr. �. Socranenm,C°Of°°i° <br /> Genonalor's US EPA ID No. fAonifert Document No. 7. Page 1 Ina.aH.a the shaded areae <br /> UNIF AA HAZARDOUS is not recluired by Federal kw. <br /> W TE MANIFEST C A101010191519101615131 f l <br /> 3. GeneratorlLNorti and Mailing Address <br /> N Adv _tel Plating <br /> n 4421 Gi.annecchini Lane, Stockton, CA 95206 <br /> N <br /> A. Gerrorator'r Phone (20()) 982-1104 <br /> S. Transported Company Name 6. US EPA ID Number - <br /> W <br /> 21st Cemury EMI INIVID191810181915338 <br /> Q7. Transporter 2 Company Name R. US EPA ID Number <br /> U <br /> Q <br /> Z 9. Designated FacilityName and Site Addms 10. US EPA ID Number <br /> ~ W 21St Century ESa <br /> o 2095 Newlands Drive, East <br /> � 'a NV 89408 N V D 918101 <br /> 81915 3 3 8 <br /> V - 12. Container, 13. Toted 11. Unit <br /> (� Z 11. US DOT DescriptioQncludinq Proper Shipping Name,Hawrd Clan,and ID Number) No. T YA d <br /> a.RQ, Hazardous Waste .SaoliYi, N.Q.S., 9, NA 3077, -- <br /> 3 -G PG III, (Hydroxida Sludge) <br /> o00 c E <br /> d N b <br /> E <br /> R ' <br /> A <br /> m T C. <br /> O <br /> � R I <br /> w I <br /> Z d. <br /> W <br /> 1J <br /> f <br /> W <br /> N <br /> Z <br /> a <br /> N <br /> W <br /> fY <br /> J <br /> z <br /> I <br /> 13. Sp«Lai Handling InsiruHions and Additional In}ermolion 1 <br /> a Wear protective clothing as rc>quixed 24 Hour FSnergency Phone: 800-641-9931 <br /> z ERG #31 National Pesponse Center: 800-4244802 <br /> J <br /> 16. GENERATOR'S CERTIFICATION: I hereby decks that the cat a of thita lgn w an fully and accurately described above by proper shipping home and are dandified <br /> Upacked,marked,and labeled,and are in all respect,In proper e.pon i«transportby highway according to applicable International fntdipai gownxnant rogu ,� .. <br /> If 1 am a large quantity generator, I certify that I hove a program in plan to reduce the volume and toxicity of wart,generated ft th,degree I fiesta data to be, <br /> —y economically practicable and that 1 have selected the practicable method of treatment,storage,or disposal currently available to ma which mhladwr the praml and fulun <br /> U) threat to ham.health and the environment;OR,if I am a small quantity generator,I has made a good telth effort 10 maimxe my wade generation and wad ds beef <br /> K <br /> waste management method that is available to me and that I can afford. u <br /> Q, P�rint./ed/'Typed Nama Signature Alerdh Day Y ` <br /> dr <br /> W1 17. Trampciivrr 1 Acknowledgement of Receipt of Material, o <br /> (� 'A. no <br /> / d N me by(�_ Signatu Month Day Year_ <br /> F 1 <br /> w 0 18. rote rter 2 Acknewled meM of Receipt of Materiah <br /> w T Pdrded/Typed Name SigrwNro Amuplb Day Y <br /> 0 : . <br /> 'Wo <br /> }r 19. Discrepancy Indication Space 1, <br /> Z 'C- <br /> L ' <br /> I, 20.Facility Owner or Operator C.dific0cm of r«ei t of hazardws mamrah c ad Ty thb manifest except as noted <br /> Tdmed/TypAl <br /> ed Name SI ro ortlh Day Y. <br /> f. L . Gi <br /> DO NOT WRITE BELOW THIS LINE. <br /> Yellow: TSDF SENDS 1HIS COPY TO GENERATOR WITHIN SO DAYS.' <br /> vft3t.tvt -'p: n,,. (Generakr'who wbmit hazardous waft For tranwart aghef-dole f <br /> DT3C 8022A (1/93), •• produce completed copy of thh.ebpy and wind to DT$C wilhin:30 <br /> EPA 8700-22 <br /> , r�F,i„ t1rl• 'LE: - _„ Jf ; i a t.`. <br />
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