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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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JACK TONE
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2200 - Hazardous Waste Program
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PR0539709
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COMPLIANCE INFO_PRE 2019
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Last modified
12/6/2018 1:21:55 PM
Creation date
11/6/2018 8:39:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO_PRE 2019
FileName_PostFix
PRE 2019
RECORD_ID
PR0539709
PE
2220
FACILITY_ID
FA0017952
FACILITY_NAME
PACIFIC SOUTHWEST IRRIGATION CORP
STREET_NUMBER
8372
Direction
S
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
18308005
CURRENT_STATUS
01
SITE_LOCATION
8372 S JACK TONE RD
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS3\222IAError\IAError\J\JACK TONE\8372\PR0539709\COMPLIANCE INFO .PDF
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EHD - Public
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03-04-'15 15:51 FROM- <br /> oles Environmental 661-322-880 T-454 P0008/0012 F-956 <br /> RECEIVE <br /> - ) A,pPllcable Cerficafkous APR 08 2015 <br /> PAI2TIT1. AutharizedRe resenfative ENVIRONMENTAL <br /> 1 T <br /> cmley@OvatonProfilnNumbor T <br /> . MsniG-wend hinelrsmNam6eraesodekdvAsh weese shlpmanl <br /> FaM <br /> ROl'.2LOR CBRTIVICAMN <br /> tor's Cerufiogtion(266.7(a)(2)(to)for waste that meets Trcgoa, kstandards <br /> under penelty of law matlpoxveml(y have erarutned and am famlliar with the vlaste through auelysis <br /> hsg or through howlodga of tha waste to support this certiftcadon lhaf the w-ste eoroplies vyldr the neatmmt <br /> s specified in 40 CER,Part 268 Subpartl)and all appiicabl0 prohibitions set&A In 40 CPR268.32 or RCRA,3004(d). Iant penalties for submitting a false cartiffcation,including tho possibility of fico and impsdsonmcnt, <br /> —2. Waste Treated to Remove Charaoterisfics(268.7(b)(5)(iv)) <br /> I certify uoderpeaalty of law thatthe waste has been treated in accordance with the roquirementa of40 GFR 268,4010 <br /> romovd tha Lazatdous chataeterlplio, '[Isis deohatactefized wagte confabs underlying hazardous Constituents that <br /> Yeglrire furdteC tYentmaat f0 mestUalvorealtreamteRC 8t9adards. I am aware that thar08te signirsoentpenaldes for <br /> aubm3ttagafalseao caHonincludtnythepossibilityaff7nCattdsuprisoument <br /> 3. DebrlsTreated toMont Alternative5tatrdards(268.7(d)(3)(tii)) <br /> Xc4*umlerpenaltyoflaw-that the dabttshasbean mated inaccordaumwiththcmqukc;ueatsof40C (Ri.45, I <br /> am awarethat there are algnsfrcantpeniltles for making a false cstNfieaflon including tbepoxslblllty offmoaad <br /> lmprleenmanL <br /> 4.Y ab Packs to bn Treated byXncinera(lon(CarflfiQad0P mast be completed)Appendlxl'V Lab Packs <br /> • ICert%'Urlderpenalty OflnwthatSbavcpersonagyexammedandamfanvVarwith thewaste land that&alab pack <br /> contains only wastes whit)LhavonotbeanowludodundarAppandkIVto 40OMPart268 or valid wastesnotsubject <br /> to xegulation.uu&i.40 CPR part ZOxl i pm hi?w tht these are sipiffontpeaaldes kbr subnrittinga6fse cer6Goa&on, <br /> ICoIudingthe posalbi[iry of flue or lmpdeonmenY. <br /> 5. Appand9s V Lab Pgoks ' <br /> ICcrtifyunderpon9l(voflawthatTperaonallyhaveexemtuedpndamfaatlliarPdthdrewaetefluouglragaU�sis(eattngor <br /> throughknowledge of the waste and that the lab Rekauntalas only orgauie waste specified in Appeadlx'V to port 268 <br /> at solidwastesaot subjeatto regulation uadarFwtz61. I amaware thatthere are aignilloent ponaltioe for sabmitting a <br /> false st¢tification,jgefudilrg�ra possibility oPfigo ox irnprisonmenk <br /> Signature XrinENume // <br /> Data <br /> TWO en't ✓' <br /> 3 CPS ' <br /> i <br />
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