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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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PR0518767
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COMPLIANCE INFO_PRE 2019
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Last modified
12/5/2018 11:46:56 AM
Creation date
11/6/2018 8:39:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO_PRE 2019
FileName_PostFix
PRE 2019
RECORD_ID
PR0518767
PE
2220
FACILITY_ID
FA0011160
FACILITY_NAME
ADVANCED INDUSTRIAL COATINGS INC
STREET_NUMBER
950
STREET_NAME
INDUSTRIAL
STREET_TYPE
DR
City
STOCKTON
Zip
95206
APN
17728052
CURRENT_STATUS
01
SITE_LOCATION
950 INDUSTRIAL DR
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS3\222IAError\IAError\I\INDUSTRIAL\950\PR0518767\COMPLIANCE INFO PRE 2016.PDF
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EHD - Public
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Stade at Cegtomia—FWlin and Wei Nn Agency v,./ \�/ DaPartment of Health Sarvltes <br /> Toxic Sup lancet Control Division <br /> r- Sacramento,California {yy <br /> Pror•a print w fv{.+ IFwm MPnnH for use on elite 1 Dpnchl ry"Wroa,I 4f4 <br /> ,A U.MFOte?iRAZARUOUS ^Ar I.ti o. t'anl eat age In ormauon int as hadea areas , 11 <br /> (f{t 4L Document Na ' Is not required ii Federal <br /> �9'P.sTE ?1A1VIF'cST O of la,, <br /> J. a"rlllor s Name and admg Add,as, A. ManiftiSt ltocumect 'iUffd a <br /> UNIVERSAL RLMLE CORP, 84116985 <br /> P.O. BOX 6395 STOCKTON, CA 95206 Illistaft Generatora <br /> IV <br /> Csen!re:orY Phone 1 <br /> Iraniporeer ompany ams6. US EPA to Number :ice ranr7orters ID1E^y <br /> ROMIC CHEMICAL CORPORATION C A D 0 0 9 4 5 2 6 5 7 .7if"Ponars Phone — I <br /> ron•portsr 2 comp—S-M-Y—VaiRe— US EPA ID Number - ,i.,Mto ransporter s 10E <br /> F."rem--porters Phone <br /> j <br /> W. Dosagnered Facility Name and Site Ad&ess 10. <br /> US EPA to Number CIStato Fawilwo <br /> ROMIC CHEMICAL CORPORATION CAD 0 0 0 4 5 2 0 5 7 <br /> i 2031 Say RoadTM a n• _ <br /> East Palo Alto, CA 94303 IC A D 0 0 9 4 5 2 6 5 7 (415) 324-1638 <br /> I 12.0onulners 1 13. 114. <br /> 11.US DOT Description(Inciedmg Proper Shipping Name,Hazard Crass. and!D Number l I Total Unit t. f <br /> _ I No. Type Quantity, Waste No. <br /> �; a ------- l!N19193 I � <br /> ACETONE SOLVENT (FLA°'(`1ABLE LIQUID)A=U 1 . TT �' 352 7 <br /> C. , " <br /> d ` x/ 14.1/ <br /> IlliY <br /> ! '�J ttorla��socnpuons Tor ite'ia-a st.a Above K.Handling codas for wase•Usted AboveC <br /> MIXTURE OF ACETM TRI. HI )RATE, .(FILLER, 01 <br /> CALCIL14 CARBOMTE (FILLER) M.E.K.P. (HAVIER) <br /> I <br /> j ! i b.Special Handling Instructions and Aodlbonal information <br /> Gloves, Goggles and Protective Clothing (CAUTION, FLA^TIABLE) REFER TO ATTACHED M.S.M. I <br /> E R I I i N:!hereov declare that the contents of this gonsignmentitre ully ands urately described <br /> above by proper shipping name and are classified.packed,marked.and I ibai ,andaroinalliespectstnp condnionfor <br /> .l transport try highway according to applicable International and national go rnmental regul ns.,r moi' <br /> /� I Date <br /> Printed 7N a me S n to .i r r Month Dar Year <br /> r. H Jwiit A. POTTS i /�i ; f/„ ? <br /> T 17.Transporter 1 Acknowledgement of Rocvpt of Materials Date - <br /> n <br /> n Pnn1sd,'Ty7ed No Igura, Month Day Year <br /> O 18~Transporter 2 Ack howl edge Ment or Receipt of Materials Date <br /> - <br /> T. I Pnntso.?yped Name Signature Monte Day Yser 11 <br /> 19.Discrepancy indication Space (A <br /> A G <br /> L <br /> 1 `20 nsmht Ownet or Operator. Certification of receipt of hazardous materials covered by this manifest except as noted in <br /> ate <br /> (-- r s1C711 v, Nrrrrb�Qhn to <br /> �. Afonrn bay Yaer <br /> eutler-br <br /> Peter Schneideror Gre Ellison <br /> Where: TSDF SL14DS THIS.COn TO DOHS WITHIN 30 DAYS <br /> DHS$022 A (7raa) TO: P.O. Box 3000 cromento, CA 95812 <br /> (EPA 9700.22) M aall <br />
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