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COMPLIANCE INFO PRE 2019
Environmental Health - Public
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2200 - Hazardous Waste Program
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PR0514402
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COMPLIANCE INFO PRE 2019
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Last modified
9/6/2019 11:23:32 AM
Creation date
9/6/2019 9:59:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0514402
PE
2227
FACILITY_ID
FA0010746
FACILITY_NAME
JAAS AUTO SERVICE
STREET_NUMBER
414
Direction
W
STREET_NAME
CHARTER
STREET_TYPE
WAY
City
STOCKTON
Zip
95206-1707
APN
16503004
CURRENT_STATUS
01
SITE_LOCATION
414 W CHARTER WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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_ __-_ = SERVICE ORDER <br /> No. N 286315 <br /> ASBURY EWRONMENTAL SERVICES <br /> 2100 NORTH ALAMEDA STREET ❑ COMPTON, CALIFORNIA 90222 ❑ (310) 886-3400 <br /> SAN DIEGO OFFICE NORTHERN OFFICE <br /> 1-800-748-5744 EPA NO.CAD028277036 1-800-727-2879 <br /> 9-40-92 <br /> 1-800-933-9194 /` <br /> DATE 1`40-f 2 _. ONE TIME PICK UP ❑ YES or Q'NO <br /> r� rte- <br /> O r. .. <br /> CUSTOMER j 7 T- "�•�r.0 RESIDENT ❑ YES or O O" <br /> BILLING ADDRESS CONTRACT CUSTOMER ES or E NO <br /> PHONE ,�:� �II: " f.3�-„�,{ CONTACT - ACCOUNT NUMBER <br /> CUSTOMER EPA M AMOUNTy- <br /> JOB SITE ADDRESS 7�f * j" 7 I e fe !✓ CHECK NUMBER <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> l�ola+0 <br /> NOTES: COMMODITY dam,J <br /> HALIDES P.P.M. <br /> '4'SMBUSTIBLE LIQUID, N.O.S., <br /> (Used Oil/Contaminated Petroleum Products), NA1993, PGIII <br /> ❑RQ, ENVIRONMENTALLY HAZARDOUS SUBSTANCES, LIQUID, <br /> NOS, (Ethylene Glycol &Water), 9, UN3082, PGIII NEXT SERVICE DATE <br /> ❑ U.S.DOT DESCRIPTION: DRUMS <br /> NO.OF GALLONS / <br /> MANIFEST NO. 7 -+`'Y~ - - <br /> DRIVER l l-• TRUCK NO.&RT <br /> - -DESIGNATED TSDF: ❑- ALVISO INDEPENDENT OIL- 5002 Archer St. -Alviso, CA 95002 <br /> ❑ BAYSIDE OIL Il, INC.-210 Encinal St.-Santa Cruz, CA 95060 <br /> ❑ BC STOCKING -7300 Chevron Way-Dixon, CA 95620 <br /> ❑ DeMENNO/KERDOON-2000 N.Alameda St.-Compton, CA 90222 <br /> ❑'DCS- 3256 N. Marks St.-Fresno, CA 93722 <br /> C1, RAMOS ENVIRONMENTAL- 1515 S. River Road-W. Sacramento, CA 95691 <br /> This Is to certify that the above named articles are properly classed,described, packaged, <br /> marked and labeled,and are In proper condition for transportation,according to the applicable <br /> regulations of the Department of Transpona8on. <br /> f <br /> I HEREBY CERTIFY THAT I HAVE NOT MIXED {f <br /> THIS WASTE WITH ANY OTHER WASTE,AND THE CUSTOM R SIGNATURE DATE —c <br /> TOTAL HALIDES ARE LESS THAN 1000 P.P.M. <br /> I FURTHER AGREE TO ACCEPT THE ADDITIONAL V^ '� <br /> CHARGES FOR LEGAL DISPOSAL IF THIS WASTE X <br /> PRINT NAME <br /> IS OVER 1000 P.P.M.TOTAL HALIDES ,. ,:� <br />
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