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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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2200 - Hazardous Waste Program
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PR0514138
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
2/28/2019 4:22:31 PM
Creation date
10/31/2018 12:27:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0514138
PE
2230
FACILITY_ID
FA0010034
FACILITY_NAME
PNP Stockton #80
STREET_NUMBER
3927
Direction
E
STREET_NAME
CLARK
STREET_TYPE
DR
City
STOCKTON
Zip
95215
APN
17917109
CURRENT_STATUS
01
SITE_LOCATION
3927 E CLARK DR
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\C\CLARK\3927\PR0514138\COMPLIANCE INFO 1991 - 2011.PDF
QuestysFileName
COMPLIANCE INFO 1991 - 2011
QuestysRecordDate
11/14/2017 5:47:21 PM
QuestysRecordID
3727153
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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) t <br /> Please clot nr type.(Form designed for use m elite 12 'ch) er.) ? Form Quad.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Germaly IONumbeW 2.Pagelof 3.Emagawy3esponsa PMre .Men8esl Troa ng umber <br /> WASTE MANIFEST GAL 0 0 0 2 6 9 3 7 6 1 0 A1/-9300 JJK <br /> 6,Genoslals Name and Me"Pdaess Gsreretah Silo Addreea(A dAerenl dam maYYg eddraas) <br /> PICK N PULL AUTO DIMMLERS STOCKTON LLD <br /> , W7 CLARK OR <br /> STOCKTON CA 06206 <br /> Ganerobfa Ptane: 70B •� <br /> U.S.EPA m Nufria <br /> e.7ii a 1 Cmpany arae <br /> ASBURY ENVIROM"TAL SERVICES C f1 0 2 8 2 7 7 0 3 6 <br /> 7.Transporter 2 C ".y Noma U.s.EPAID umber <br /> B.Oeslpnaled Faaily Nemo aM SaAddess U.3 FPAIDNmlber <br /> OK DIXON r. <br /> 7300 CHEVRON WAY <br /> DIXCNI CA %VO �j A1',T 0 8 0 0 1 2 6 0 2 <br /> F a Ph". pD71893.8009 <br /> 9b.U.S.DOT DOW"m Cxakxyeq proper Name.Hawd Class,ID Maher, 1� ' 1 1i.� . 18.MMMCod" <br /> Querft HM and Psddtp GraN(fMy)) <br /> NON•RCRA HAZARDOUS WASTE,LIQUID(USED 01LAIXED OIL) i <br /> 001 TTD Q.. <br /> 2. <br /> r <br /> a ` • <br /> 14.S aMEng IWnMm aM Add&W l*m*5M ' <br /> NAER(3$ bbl ' 171 'PROFII.F-$981 DK100184a ADDITIONAL FPA 000ES 981 .,NONE'APPROPRIATE PERSONAL <br /> PROTECTIVE EOUIPMNT <br /> 16, GENERATOR'SIOFFERORS CERT IFICAFlo N:.hereby declare bat the con l51 Its u1OAa paelpnn: axe IsM� ae017 q'g1B °I U" 8•eN are tlaadAM,pack�ged. <br /> w,ked aM bbe**Warded,aM ere In a roap"In prow aMNon w transport sommN to eppdcath MematloW and ne6oiW govemrorAsi r@gWa,6ms,HexpM 0AWnw ora I mm Navy <br /> Expo af.I ON*that the c umts ofoftnog~conbrm to 6a tame of Sia alllo'Ad EPAA*#Modrwt af0oneenL <br /> im*tmt Newa*n*iknwoDnw IndOCFR26237(e)(Alsmalarwquwmygmodo)a )(rtl emaemeA quer (anMeta)MYue. Move Day Year <br /> '. <br /> 0 bf Hama <br /> a m-fa obnpalto U.S. ❑Export h.U.S. Portcgw*woldt <br /> �trgnepprtar tylra6xe(M expale ). Oab tae U.S.: .. <br /> 17.TrrvepftAtim00edgirdof Recelptol M$Wds pay •Year <br /> Trenapalal PeAName Y° <br /> TrenepoAajAw arae SlpWxe MaMh Day Year <br /> 18.Dimpars' <br /> 168.DLW"Grq bGmWn SP" ❑ Ouvw ❑Type EIRew. ❑Partld R*l dm ❑Full R*cd. <br /> Alerifelt Re NarLer: <br /> U.S.'EPA IO Number <br /> f6D.ANamete Fatldy(a Generale) <br /> FmWs Phms: b D&y Year <br /> ® 6o.Slgntum to 5ow(a to <br /> 1B.Hazudous Waste Repod MewgenaM McOwd Cedes Q.e.,edea lar haxardae waste uealnwnl dlspaal,eM recr3np systema) <br /> 2. <br /> 20,04sOVetsd FacikyO �ro Operelx Ceres bOn OtMOOVOfhmrdousmeleddemvaradWNemaNlM except as ndsd in IN1 monthDay Year <br /> ml ypM Neme Sgnalure <br /> EPA Form 870042(Rev.3-05) previougledrWos are obsolete. TRANSPORTER'S COPY <br />
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