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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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G
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GRANT LINE
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3010
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2231-2238 – Tiered Permitting Program
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PR0506938
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
8/31/2020 2:05:45 PM
Creation date
7/30/2020 7:43:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2231-2238 – Tiered Permitting Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0506938
PE
2233
FACILITY_ID
FA0004548
FACILITY_NAME
WALMART #2025
STREET_NUMBER
3010
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
238-020-15
CURRENT_STATUS
02
SITE_LOCATION
3010 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
FilePath
\MIGRATIONS\Tiered Permitting\G\GRANT LINE\3010\PR0506938\COMPLIANCE INFO.PDF
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EHD - Public
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EPA ID NUMBER CAL000126635 Page 3 of r <br /> VIII. CERTIFICATIONS: This form must be signea by an authonzed counorare ojJieer or any other person in the company was <br /> has operatuonai control and.performs dedtion-mating functions that govern operation of the faciliry(per Tule 22. Ca"ornm <br /> Code of Reguiations (CCR) Season 66270.11). All three copier must hawe original signanuv. <br /> Waste Minimization I certify that I have a program in place to reduce the volume, quantity, and toxicity of waste generated to the <br /> degree i have determined to be economically practicable and that 1 have selected the practicable method of treatment. ator"e, or <br /> diaposai currently available w me which mun;m= the present and future threat to human health and the environment. <br /> Tiered Perntitting Certification I certsfy that the unit or units described in these documents meet the eligibility and operating <br /> requirements of sate samtes and regulations for the indicated permitting tier, including generator and secondary containment <br /> requirements. I understand that if any of the units operate under Permit by Rule or Conditional Authorization. I will also be required <br /> to provide required financial •«ra*+ce for closure of the treatmrnt unit by January 1, 1995. <br /> I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance <br /> with a system designed to&&sore that qualified personnel properly gather and evaluate the information submitted. Based on my miFry <br /> of the person or persons who manage the system or those directly responsible for gathering the information, the informatinn is. so <br /> the best of my knowledge and belief, true, accurate, and complete. <br /> I am aware that there are substantial penalties for submitting false information. including the possibility of fines and imprisonment <br /> for!mowing violations. <br /> Mice Wissel Quality Assurance Coordinator <br /> Name(Print or Type) Title <br /> 08-30-95 <br /> Signature Date Signed <br /> OPERATING REQUIREMENTS: <br /> Please note that generators treating hazardaur waste onsite are required to comply with a number of operating requirements wltidr <br /> differ depending on the tier(s). There operating require meets are set forth in the statures and regulations, some of which are <br /> referenced in the 75er-Specific Fact Sheets available from the Department's regional and headquarters officer. <br /> SUBMISSION PROCEDURES: <br /> You mart submit two milia of this completed natificarion by terrified mail, return receipt requested, to: <br /> Department of Toxic Substances Control <br /> Program Data Management Section <br /> 400 P Street, 6th Floor, Room 4453 (walk in only) <br /> P.O. Bar 806 <br /> Sacramento, CA 95812-0". <br /> You must also submit one copv of the rorification and attachments to the local regulatory agency in your jurisdiction ar listed m <br /> Appendix 2 of the instruction marenals. You mart also wain a copy as part of your operating record. <br /> lI ulnae femur must hawe o it signarwer, nor phorocopiu. <br /> DTSC 1772 (1/95) Page <br />
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