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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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JACKSON
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2501
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2200 - Hazardous Waste Program
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PR0518565
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
12/6/2021 1:14:43 PM
Creation date
7/21/2021 11:36:46 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0518565
PE
2220
FACILITY_ID
FA0003910
FACILITY_NAME
H&M - BW #98
STREET_NUMBER
2501
STREET_NAME
JACKSON
STREET_TYPE
AVE
City
ESCALON
Zip
95320
CURRENT_STATUS
01
SITE_LOCATION
2501 JACKSON AVE
P_LOCATION
06
P_DISTRICT
005
QC Status
Approved
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SJGOV\gmartinez
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EHD - Public
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Please-printortype - r `i' FormAppr`dved QMBNo '20500039 r' <br /> UNIFyDRM NATARDOUS WAST♦=iMANIFESF 21 GeneI . t 11 rID N2y per ! { f ,+ 22 ppge', ?3FJrtwiliestJ+ Tl)ind ryr)mpe� t yr :- �, b i <br /> Coritihudtlon Sheet ' r( �' 1 �r �� tzr r r' ° d r + ,eI <br /> ( ) r 7 t �s & Iz res ,y f pI Fr <br /> Generators Name ! Cz f?L r /n ai / ./,} ^ <br /> :, f � ) � .rr <br /> 25� Transpoper�•) Company NameJ U EPA ID Number t <br /> �` tar (�'�f t .;j :- ���j 1C7'pf Jl�'` p ", i`,-%r't � �/ C c.✓'`; �' (i' 61,! ) `/�� ` ��`� C�- <br /> 26. Transporter Company Name U.S'. EPA ID Number - <br /> 27a 27b U.S. DOT Description (including Proper Shipping Name, Hazard Class ID Number, 28. Containers 29 Total 3D Unit <br /> p I( any)). . _ i t 31 Washe Codes_ <br /> and PaclS(g-°s�Irou -� , „ .... :;_ . 9i 8 r:' :: '.ryo'=l?' } '1 ,Syp9: ;':<. Quardil L WfjNol. ' �: A•-- .. <br /> Z <br /> wU' <br /> w <br /> _ ..,« : . ,,..r_ .vu.v�++..-.v . ..v..a -ia. �.» ..J=r. ( nra ,e.s%M .�- .J«sa..e— a..'e,�a -t.,.,::tia.w--,� , r*-'ti . ''r.v+.< .1..�...- ��.. x� .t• _ n-. . :, <br /> 32. 5 Special Handling filing instruct ons and Additional information I L L L `; <br /> 93Trans onersp ' AcknoW ledgment f Receipt of Malenals " ` ' . , ,. , , :.u.( , <br /> . . ;_ <br /> Pdnledfryp dNamg, '.n ! T �^ SlgnatuJ ,Yar <br /> Z 34. Transporter _Acknowledgment of Receipt of Materials ] L,_ ,f <br /> PAntedl�yped Name /`/ `Signature L Month Day Year <br /> 35. Discrepancy <br /> J <br /> pi <br /> , <br /> Q36. Hazardous Waste Repod Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br /> z <br /> e7 <br /> rn <br /> w . <br /> EPA Form 8700-22A (Rev. 12-17) Previous editions are obsolete. . DESIGNATED FACILITY TO GENERATOR <br />
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