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CO0020030
Environmental Health - Public
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2500 – Emergency Response Program
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CO0020030
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Last modified
8/29/2023 3:36:33 PM
Creation date
2/12/2019 12:43:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0020030
PE
2546
FACILITY_ID
FA0012979
FACILITY_NAME
FLYING J INC*
STREET_NUMBER
15100
Direction
N
STREET_NAME
THORNTON
STREET_TYPE
RD
City
LODI
Zip
95242
ENTERED_DATE
11/25/2003 12:00:00 AM
SITE_LOCATION
15100 N THORNTON RD
RECEIVED_DATE
11/21/2003 12:00:00 AM
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\bmascaro
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FilePath
\MIGRATIONS\T\THORNTON\15100\CO0020030.PDF
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EHD - Public
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11/21/2003 14:35 2093394287 FLYING J PAGE 04 <br /> i Mailing:P.O.Box 176,Salida,CA 95368 <br /> r �I ��f� 4612 Kiernan Court,Salida,CA 95368 <br /> George W. Low' '� " `r' Phone:209-5454791 FAX 209-645-2241 <br /> J, <br /> Environmental Services Division EPA#CAR000047019 <br /> wok ' CA Transporter Number 3844 <br /> CA License#758518 <br /> NE R: <br /> Site EPA ID#: � �, ;_ Consolidated Manifest Receipt: 9907 <br /> Contact Person: 7 Shipment Date: <br /> Name: <br /> Address: Driver Signature: <br /> City, State, Zip: Truck# 4 <br /> Site Phone: <br /> Product Waste Manifest Quantity Units Price Amount <br /> Code <br /> Non-RCRA Hazardous Waste Liquid(Used 011):Lubricating 221 GAL <br /> Non-RCRA Hazardous Waste Liquid(Used Oil)-industrial 221 GAL <br /> Non-RCRA Hazardous Waste Liquid(Used Automotive Antifreeze) 135 GAL <br /> on-RCRA Hazardous Waste Liquid(Oil&Water) 221 t 7 ; GAL <br /> on-RCRA Hazardous Waste Solids Contaminated with Used Oil 221 <br /> Drained Used CII Filters Drums) <br /> Waste solids&Sludge <br /> Wash Out <br /> Empty Drums EA- <br /> nspartatlon&Truck Tlma HR. ✓` ,' <br /> Hazardous Test <br /> I <br /> Unloas o9rerwise specified on this consolidated Manrfest Receipt(invoice)Terms:Accounts due on the 10th of the month following month of purchase,Pant due Total A <br /> < <br /> accounts will be charged a FINANCE CHARGE at the PERIODIC RATE of 1-1/2%w month,which is the annual PERCENTAGE RATE of 18% f <br /> By signing this receipt,the Generator certifies that a program has been established to reduce the volume or quantity and toxicity of the hazardous waste to <br /> a degree as determined by the generator,to be economically practicable. <br /> Generator certifies that all Hazardous Waste listed on this Consolidated Manifest Receipt is profiled to meet the Waste Codes as listed above. <br /> Signature of Generator, Representative or Agent of Generator: x <br /> Recycling & Disposal Facilities <br /> C3 C2 <br /> Greenleaf Environmental Ameridean <br /> 3474Toyon Cr, 2430 Almond Dr. Name: <br /> Valley Springs,CA 95252 Silver Springs,NV 89429 <br /> 209-754-4600 775-577-9001 Address <br /> CAL000214411 rLNVD982358483 <br /> . <br /> /1 Y' City,State,Zip: <br /> l 1 ) , �,f�, . ,� <br /> P.rbankDillTransfer CRI Recycling Service,Inc. <br /> 5300 Claus Road 101 Hagan Drive Phone' <br /> Riverbank,CA 95367 Woodville,WI 54028 <br /> 209-863-8181 715.698-3363 <br /> CAL000190816 WIR000029751 EPA ID: <br />
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