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CO4GF0XEK
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2500 – Emergency Response Program
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CO4GF0XEK
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Last modified
3/3/2021 2:51:34 PM
Creation date
3/3/2021 2:16:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO4GF0XEK
PE
2546
STREET_NUMBER
1740
STREET_NAME
HOUSTON
STREET_TYPE
AVE
City
STOCKTON
Zip
95206
APN
16307036
ENTERED_DATE
2/25/2020 12:00:00 AM
SITE_LOCATION
1740 HOUSTON AVE
RECEIVED_DATE
2/25/2020 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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J <br /> Please pont or type. <br /> UNIFORM HAZARDOUS WASTE MANIFEST 21. n I u r � sForm Approved,OMB No.2050-0039 <br /> 22.Page z i aclif <br /> (Continuation Sheet) <br /> 24.Generator's Name 2 of 2 � <br /> i <br /> �q - 1 <br /> (� I <br /> 25. Transporter_ _ Company Name TASh"Motor T1 U.S.EPA ID Number <br /> oaoaAar dit% <br /> AR <br /> i 26. ?ransporter_ 1. Company Name U.S.EPA ID Number <br /> �ea r1 4 v1.4 41 yov, SU I I%A za d <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers <br /> HM and Packing Group(I any)) 29.Total 30,Unit <br /> No. Type Quantity Wt./Vol. 31.Waste Codes <br /> OO <br /> w <br /> Z <br /> w <br /> 32.Special Handling Instructons and Additional information <br /> w 33.Transporter Acknowledgment of Receipt of Materials <br /> w PrinledlTy d <br /> ry - l._.1"�`•-'*� Signature Month Day Year <br /> Z. 34.Transporter Acknowledgment of Receipt of Materials <br /> Printed/Typed Name 1 , t SignAu 6kmfh Day Year <br /> VV I'414 <br /> 35.Discrepancy IS 26 <br /> J <br /> U <br /> Q <br /> LL <br /> LL) <br /> Q 36 Hazardous Waste Report Management Method Codes(i.e,codes for hazardous waste treatment,disposal,and recycling systems) <br /> z <br /> U) <br /> w <br /> 0 <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br /> n«n uw.Ann.6'—"..w....�r.w.+..i..�*-#b-^..d <br />
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