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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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W
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WILSON
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130
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2200 - Hazardous Waste Program
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PR0514406
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COMPLIANCE INFO PRE 2019
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Entry Properties
Last modified
2/27/2019 8:11:58 PM
Creation date
2/27/2019 3:52:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0514406
PE
2220
FACILITY_ID
FA0003601
FACILITY_NAME
ARCO STATION #826951*
STREET_NUMBER
130
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205-5561
APN
15502064
CURRENT_STATUS
01
SITE_LOCATION
130 S WILSON WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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-Pr <br /> Please print <br /> Pto.2050-0039(ExPtns I <br /> o�ry fqr°��i ljal l►;ra�w.ir.r Ses lnstruct;ons on by-1- of page f5..' <br /> Department of Toric Sulawli r Conti <br /> UNIFORM HAZA►RDOU Garterarors US EPA 10 No, — �� nM.r.Caf forma <br /> WAS ManHe,t Doetsrrsenf No. 2. Paye 1 1nfo,m.ton ie the shaded araas <br /> R TE MANf�EST � Q• <br /> J erolw's Naate Illny Add s I , C •� p 5 1 's fOI required by Federal law. <br /> A- to Manifest Dacvstter,f Nutn6er <br /> �" S Evia 20826845 <br /> arorIrt sf�► G A 1v as <br /> `^ n. 51011.C-awlaw I ID <br /> 5'r 1;.�. <br /> S. Try risporter 1 (7anpany Name <br /> 6 US EPA ID Number C. StvN Transporter's ID(Reierved,f <br /> .cJ ) U I D. Iransporter•s Phone <br /> �. Tr sparter 2 Corn (S'Ila)?Y9 <br /> Pony�'se I B• US EPA ID Number <br /> 7 - t.•$tate rronspat✓,Id IStJ:r'vd•1 <br /> 1. �. TronsperMr's Phone <br /> 9• pnard Facility Nome and Site s <br /> Q 10 U3 EPA W Nsenber *. ell O. Slate Facill 10 <br /> ny . C AI-T c7<'e Q I ? 3yC L H. frh _ 1 1 1 1 i I 1 I I <br /> a� fvK CA QO) Z <br /> -7100 <br /> V 11. US T 0esmption(incl <br /> uding Proper ihWinq Nome,Hazard G16s,,and ID Number) 12. Containers 13. Total 14. Uwif <br /> el Z o. No. T Quonwfy Wt/Vol I. Waste Number <br /> i t! Gt z A ,(au s ��lui '�' ` �;�i let►/:1 style <br /> t <br /> o N <br /> 00 E <br /> �+ R <br /> IV A i IPA/other <br /> T c. i State <br /> R <br /> w El'A/Oche, <br /> ZI Stow <br /> LLI <br /> sst ' 1 T 1. <br /> V IJ <br /> EPA/Other <br /> N . <br /> fi <br /> Z ,' C�eacr 'fer 04 <br /> s 1 ling Codes VrWas11es Usrod Aboallw <br /> i: <br /> i0• 15. Spee Handling InstruMivns and Addill Infoxrrrofion p(�,, { � 1 <br /> a � '�'JMp./ I p`i)��l" i:T 1� L^�I�_I'1 -Yf.r►V1 ltraG>, . <br /> Z S 11 <br /> z J .w <br /> A Ill <br /> 5 " <br /> Toy's CETfTIfluTwrtl: I herebj � <br /> mor OR labeled.and ore In allresp" <br /> That ef~`r s of this es pnwwnr w/ally and ac�erolelr des ribed oboe by proper shipping name and ore clas,iheci�packed, <br /> V r sp"in Proper condition far kan {sy ghswy according to o;Ticoble internarionol and national <br /> govemmenl regulations. <br /> )1f 1 <br /> 04 a large gswnrley 94"1 tar,I certify that 1 Hari a ram in place b reduce Ow v g the degree I have determined b be emrwmically <br /> H able and that 1 1,ore seill the arr+robfe methadd tr.a"a t, Plum.and bxkly of wos+e generated ro <br /> and I e erlvirarmowi Op,if I am a ►toro9e'a Ji'pd'd<iwnenlly evoifable b am which minimizes the present and future threat to hurston heaA <br /> Q stvO1 Ir a me sesd that!can q"On 'gen.roror,l have mode a Abad faith rt b mininw:e.Tny sro,fe generation and select the 6 u w,wie man <br /> afford. .f. ssgayssenl method rlsot is <br /> IPrinted/7 Nome ` <br /> LU <br /> Z f y j�f j[ MAMA Day Year <br /> �s <br /> I" Trvt1 Acl no ement of ReMi ei✓•+asriob <br /> iR irrtsd/T Nartte i Slonatu amonth Dry Year <br /> 0 <br /> I@. Trans 2 Acknow n,of of Materials r _J <br /> Prieted/Ty vd Name <br /> AJ E Signauro µonlh Day Year <br /> Q � <br /> J 19. Discre Macy Indiconan Space <br />� f <br /> A <br /> C <br /> L <br /> l iaal Owner or 00orator urfificatron of nscejci of hazardous maerra+,covered by this manrfesr excel as noted in Hem 19 <br /> T Frins-I ad Nome <br /> Signature <br /> T I {' ��i �i C• r: _ _ _._ —� Month Day Your <br /> r:�•-;J f-�- _ALL � t; � ' ,•_ i -, I <br /> DO NOT WRITE BELOVI LINE, <br />)TSC 9022A(1/991 i Slut GtNFRATOR Sr11905 THIS COPY TO i?5C WITHIN aJ r.•4r5 <br /> kPA 8700-22 To P.O. Box dOD. Socrmmrint0, CA Y�dIl-0400 <br />
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