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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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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 <br /> VIII. CERTIFICATIONS: This form must be signed by an authorized corporate oJicer or any other person to the company xn <br /> has operattonai conurol and performs aecision-magngfunaions that govern operation of the facility(per Title 22, CaWorn <br /> Code of Regulations (CCR) Seaton 66270.11). All duw copies roust have ooigieal signanoes. <br /> Waste Minimization I certify that I have a Program in place to reduce the volume, quantity, and toxicity of waste generated to c <br /> degree i have determined to be economically practicable and that I have seiected the practicable method of treatment. atatage, <br /> disposai currently available to me which tnwimithe present and future threat to humin health and the environment. <br /> Tiered Permittirt¢ Certification I certify that the unit or units described in these documents tater the eligibility and operant <br /> requirements of state sautes and regulations for the indicated permitting tier. including generator and secondary cantainnic <br /> requirements. I understand that if any of the units operate tinder Permit by Rule or Conditional Authonzatton, I will also be regmr. <br /> to provide required financial assurance for closure of the treatment unit by January 1, 1995. <br /> 1 certify under penalty of law that this document and all attachments were prepared under my direction or supervision in acmrtim <br /> with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my tagm <br /> of the person or persons who manage the system, or those directly responsible for gathering the information, the information is. <br /> the bat 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 impris®e <br /> for knowing violations. <br /> Milce Wissel Quality Assurance Coordinator <br /> Name(Print ype Title <br /> 08-30-95 <br /> Si Date Signed <br /> OPERATING REQUIREMENTS: <br /> Please mote that generators treating hazardous waste onsite are required to comply with a number of operating requirements wiu <br /> differ depending ort the tier(s). These operating requirements are ser forth in the statutes and regulations, some of which c <br /> referenced in the Ter-Specific Fact Sheets available from the Department's regional and headquarters offices. <br /> SUBMISSION PROCEDURES: <br /> You must submit two copier of this completed notification by cerrified snail, return receipt requested, to: <br /> Department of Toxic Substances Control <br /> Program Data Managemem Section <br /> 400 P Street, 4th Floor, Room 4453 (walk in only) <br /> P.O. Boz 806 <br /> Sacramento, CA 95812-1406. <br /> You must also submit one cont of the notification and arrachments to the local regulatory agency in your jurisdiction ar Hued <br /> Appendix 1 of the instruction materials. You must also wain a copy as parr of your operating record. <br /> All tivee forms must have ortrinal signatures, not photocopier. <br /> DTSC 1772 (1195) par <br />
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