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COMPLIANCE INFO_2020
EnvironmentalHealth
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2200 - Hazardous Waste Program
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PR0514062
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
8/18/2020 3:30:34 PM
Creation date
8/3/2020 4:47:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0514062
PE
2220
FACILITY_ID
FA0003954
FACILITY_NAME
SJ CO PUBLIC WORKS CORP YARD*
STREET_NUMBER
1810
Direction
E
STREET_NAME
HAZELTON
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
15518002
CURRENT_STATUS
01
SITE_LOCATION
1810 E HAZELTON AVE
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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CSG SK-SS1--UMO-01 lohnny Owens 10/12./18 10:48 PAGE 1 <br /> Safety-M een Systems, Inc . <br /> 2600 N Central Expy, Suite 200 <br /> Richardson, TX 75080 <br /> CORPORATE: 800-669-5740 <br /> 24 RR EMERGENCY: 800-468-1760 (Safety-Kleen) <br /> 2095451011 <br /> REFERENCE NSR. <br /> CUS DMER* SA32680 San loaquin Co Maintenance 78163821-ISOSI64969 <br /> 1810 E Hazelton Ave SRVC WEEK; 2018-41 <br /> Stockton CA 95205-6232 SRVC DATE: 10/12/18 <br /> PHONE 209-468-3099 <br /> BILL TO CUSTRMVRP BILL TO ADDRESS: , <br /> SA32650 San 3oaquin Co Maintenance <br /> 1410 E Hazelton Ave <br /> Stockton CA 95205-6232 <br /> PHONE 209-468-3D99 <br /> PURCHASE DRDMfl PRODUCT/SERVICES <br /> � pp��^ pp7pp�g�^ �^ TAX EXEMPTv <br /> SERVICE/ TOTAL <br /> PRODUCT QTY UNIT PRICE TAX CHARGE <br /> 66636 USED OIL RECYCLE AUTOMOTI 334.000 0.0000 0.00 0.00 <br /> SERVICE TERM 8 WEEK <br /> HALOGEN / CLOR-D-TECT TEST RESULT PASS: PPM < 1000 <br /> 10256 FEE, 01L SERVXCE/STOP NON 1.000 182.5000 0.00 182.50 <br /> SERVICE TERM 8 WEEK <br /> ----------------------------------------- <br /> TOTAL SERVICE/PRODUCIS 182.5000 0.00 182.50 <br /> TOTAL CHARGE 182.50 <br /> CREDITS 0.00 <br /> ---------- <br /> TOTAL DUE 182.50 <br /> UNPAID BALANCE THIS RECEIPT 182,50 <br /> If high risk source, rep. certifies that load specific PCS & Silicon <br /> testing have been completed prior to pumping this load. <br /> GENERATOR STATUS <br /> CESQG: Vehicle <br /> Customer certifies that (i) the above-named materials are properl <br /> classified, packaged, marked and labeled, and are in proper condi <br /> for transportation according to the applicable regulations of the <br /> Department of Transportation (ii) no material change has occurred <br /> either in the characteristics of the waste/material or in the process <br /> generating the waste/material, and (iii) the above referenced <br /> Generator Status is correct. Customer agrees to pay the above charges <br /> and to he bound by the terms and conditions (1) set forth in (a) the <br /> General Terms and Conditions provided separately to Customer or (b) <br /> any SK agreement signed by Customer and SK, and (2) incorporated <br /> herein by reference. Unless otherwise indicated in the payment <br /> received section, SOL is authorized to charge Customer's account for <br /> this transaction. If Customer fails to make payment when due, an <br /> amount equal to the lesser of (i) 1.5% per month (18% per annum) or <br /> (ii) the maximum amount allowed by law, will be added to all unpaid <br /> amounts outstanding. Customer certifies that the individual signing <br /> this Service Acknowledgement is duly authorized to sign and bind <br /> Customer. Customer acknowledges that it is responsible for maintaining <br /> 4o-. Stat•-. and obtaining an EPA ID number if rcauired by <br />
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