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ARCHIVED REPORTS XR0010680
Environmental Health - Public
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EHD Program Facility Records by Street Name
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D
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DR MARTIN LUTHER KING JR
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749
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3500 - Local Oversight Program
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PR0544218
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ARCHIVED REPORTS XR0010680
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Entry Properties
Last modified
3/5/2019 11:39:58 AM
Creation date
3/5/2019 10:40:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010680
RECORD_ID
PR0544218
PE
3526
FACILITY_ID
FA0003870
FACILITY_NAME
SRH FOOD & GAS
STREET_NUMBER
749
Direction
E
STREET_NAME
DR MARTIN LUTHER KING JR
STREET_TYPE
BLVD
City
STOCKTON
Zip
95206
APN
14734309
CURRENT_STATUS
02
SITE_LOCATION
749 E DR MARTIN LUTHER KING JR BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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Tags
EHD - Public
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Sr9ra o! ^-yo r <br /> Carty.Appravad QMb No 20.50-0039(fX91res 9 70 991 +sr e w See jnSti�SFCt3OnS On b*Ck Ot page 6 Depamnenf of Tmuc Safaitaji;U; "frof <br /> iia er,t or tnw Farm deSrgned For-"on chte 112 POCH ypewnrer � 1.0 '� Socimnenfa ~-'a.mii�rca�� <br /> t1NIFQiIM FIAZARp�IfS 1 Gencrvrcr's US EPA ID No iNantfesr Daannenr No 2 Gage 1 ratormafron.n the shard■d an <br /> S <br /> S nor ragwrad by federal low <br /> WASTE MANIFEST q I , I^�` I/ Ts <br /> C,*nararar t Name and MaJtng Addram ^ .� A Sidle manifest Document Number a t' 3s - <br /> fro i.tc+ �. �'Y 11207 <br /> d Genew*ar's Pfiane { r I �� - '_ <br /> S Tmnsporfer 1 Company game 6 US EPA 14 Nunbvr >r Store Tyrarisporler's 10&Ltrved I s n' <br /> I T Transpo r ampany Noble' B US EPA IG Number 5frlte s <br /> F �rygn�sparter'M PAon� y;��'�+ <br /> 4 <br /> j 9 Designated Facd,y Name and Site Address 10 US EPA ID Number G_ Faafr y Fd <br /> ����/�/f>F[ �f/ �� J • `�r .�'s'u�t4�n't�r���-f+ � ��"'D r+,+^. <br /> FaCi,lty�timpte <br /> � T ` <br /> - <br /> r 12 Contpman Tato 14 Una <br /> 11 US 007 Desenptilto Oncluding Prropor Sh,ppeng Nome Hhiarr{Clm/s and ID Nvnbvr} No T e Ouansay w,fYol rh'yY mIR 1rfYaY <br /> 1L-ICft< C .�/f Ale,76,rhtl H <br /> f 1'�'O f�t fps. i <br /> �-S#ffi7G Eer- <br /> ,ice40 <br /> N <br /> c F 01a; <br /> e R <br /> C FStnle <br /> o 0 CEPA%QF}itir' <br /> v gEPwf�elise • <br /> J y <br /> J Acidtllonal 094cnpt,ons For Matyr,ols luted Abavo a a ; t f.L Kcradiing�Cr�allas for Wasan 019104Jibow r <br /> a <br /> c <br />� <br /> 15 SpW,of Hondl,ng rnsrrud one and Add banal Informotia� '� L G�I ! �r ^ <br /> t yf�y i f{ I���rf�l�Y L. 4 <br /> .IC+i f d7 r Trf I rf n� � 1 d <br /> ? !/, �+ Er b� � z7-077J 7AIP G f <br /> 16 GENERATOR'S C>RTIRCATION i hereby declare that+a canrrnra of Ph,s=16mnm"l are fully and ac-urargiy duscnh9d above by proper sh,pping norma and ore clasarhed packed <br /> m0rked and labcied and are,n alt respocis m proper candilrar,for rronipai-05y highway according to app,cable,nternananal and naa9na4 governmenP regvfarians <br /> If r am a large quantity generator I certify Phar I hove a pr ram o place to reduce the vaiumv and taatciry aF wrasta generated t9 the dagree I hove determined to be vwnarnicol,y <br /> i pracrrcgbly and Ihw I hev9 wlocrrd rbc practicable nethod aF treatment storage or dt3posal currently available to me Wh+ah n,n.mrzaS the present and Fvrure tht=P to human 14SCI F,, <br /> and the onv,ronmenl QR,i{I am a small puontrty gyncrgtor I have made 9 goad Fath effort+o rntnim139 my wrasfa ganeratlan and selecs the aesi waste management,method that is <br /> ava,lable ro me and char I Co�fkrd <br /> Pr�nladlTyped Nome Slgnatvra <br /> Myanth Day Year <br /> 4l, r►° <br /> J ,T Transporter 1 Ac wad emenr a{R9cw t of Matarmle <br /> Month Day Year <br /> p Pnntvd/Typed Nam9 Signature �t <br /> i <br /> P <br /> p t$ Transporter 2 Aeknowted vrnonr a/Siceei 1 of Matenole <br /> T PrintedlTypnd Name 7717. 1_�, <br /> "anti, ppy Maar <br /> E <br /> k <br /> 19 a,6Uepancy lndreatron Spate ` <br /> F <br />- A <br /> C <br /> f <br /> 2{1 F�crl Clwner ar Q vrotbr CartlFVcgflon Of reCe r of haxardays maror+als covered b tMt mandesr ecce r os Hared,n I— 19 <br /> F. <br /> /Typed Name 5rgn re Monrh Day Yw. <br /> I �- Da roe RIr'E sELaw is N <br />[SC B022A II/qyl "��+1]J G,-en TRANSPORTER RFTAIN5 <br /> a 8700--22 <br /> I <br /> r <br />
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