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CO0055522
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2500 – Emergency Response Program
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CO0055522
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Entry Properties
Last modified
4/27/2023 4:21:20 PM
Creation date
4/27/2023 3:35:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0055522
PE
2546
STREET_NUMBER
6444
STREET_NAME
ARCH
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
18110021
ENTERED_DATE
1/13/2023 12:00:00 AM
SITE_LOCATION
6444 Arch Rd
RECEIVED_DATE
1/13/2023 12:00:00 AM
P_LOCATION
01
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\bmascaro
Tags
EHD - Public
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Fnrm Annrnuari MAR Mn 'XIcitrinlo <br />Fr UNIFORM HAZARDOUS WASTE MANIFEST <br />(Continuation Sheet) CAR 0 0 0 3 3 0 3 6 5 <br />21. Generator ID Number 22. Page <br />2 Of 2 <br />23, Manifest Tracking Number <br />001797847VES <br />Generator's Name FEDEX GROUND - STO(.SION RAF . <br />U.S. EPA ID Number r ber Transporter Company NameVeipii4t 7-6—dezzai 52" .4, 4A,L5 4/J)nco tie,ozt30441 <br />Transporter Company Name U.S. EPA ID Number <br />I <br />27a. 275. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 28. C,ontalners 29. Total 30 Unit HM and Packing Group ;if any)) No. Type Quantity WtNol. 31. Waste Codes <br />& NONACRA. HAZARDOUS WASTE SOLID, (DEISM, <br />ABSORBENT) 352 <br />1 MI 300 P <br />8, NOMICRA HAZARDOUS WASTE SOLID, (OILY DER1D3) 332 <br />I EN 80 P <br />, <br />ce <br />0 <br />t.0 <br />z <br />Ili 0 <br />Special Handling Instructions and Additional Information 5) w,1035,299 kAzu4m011(N6) ass 6) W:1053571 kiallailmaksips <br />1E55 <br />Transporter 3 Acknowtedgment of Racal t ot Materials cc <br />ILM <br />ce <br />o c. <br />Prkited/Tiped Name / Month Day Year <br />/ 1/7,ri 1 40 W_ /5, <br />I Signature "ffe.-• <br />1 1 / 7 13 <br />(13 Transporter Acknowledgment of Receipt of Materials . g Printed/Typed Name Signature Month Day Year <br />I I I I ED FACILITY ..___ Discrepancy <br />i= .1C z <br />0 7, <br />Hazard <br />5, <br />teteilknagemeInt Method .Cod (I s azardous waste treatment, disposal, and recycling systems) <br />I I I <br />w 0 <br />I I I I <br />EPA Form 8700-22A (Rev. 12-171 Previous editions are 0-soAl IN I te. DESIGNATED FACILITY TO EPA's a-MANIFEST SYSTEM
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