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SITE HISTORY
Environmental Health - Public
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EHD Program Facility Records by Street Name
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FREMONT
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848
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3500 - Local Oversight Program
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PR0545098
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SITE HISTORY
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Last modified
12/17/2019 3:18:55 PM
Creation date
12/17/2019 3:03:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
RECORD_ID
PR0545098
PE
3528
FACILITY_ID
FA0015639
FACILITY_NAME
COLBERG INC
STREET_NUMBER
848
Direction
W
STREET_NAME
FREMONT
STREET_TYPE
ST
City
STOCKTON
Zip
95203
APN
13546010
CURRENT_STATUS
02
SITE_LOCATION
848 W FREMONT ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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1. Genoralor',US EPA ID Na- Monifut 2. Pape 1 <br /> NONHAZARDOUS � + �nf 1 8/19i2o03 <br /> WA TE MAN T <br /> a, neral ame and M irnp Add ets 6- <br /> It�`►� <br /> ra,�`� ST , Ca <br /> 1, Generosar's phone�.��►-+ , <br /> S Trnntnnrrer 1 Company Name 6. US EPA ID Number A. Trnnsparter'S Phone <br /> AWO MI ONMIU L <br /> 7. Transporter 2 Company Nome 8 US ERA 1D Number ' b. Tramnpo"r'%Phone <br /> pLLM IMCYCLING Me M.-NOM I C A R 0 0 01 A 9, 3 D (520)670-9901 <br /> 9. Designated Fecil;ty Name and Sire Address US EPA ID Number C. Facifiy's Phone <br /> Filter ROCYclina SerV:LCORe Inc. (909)421-2012 <br /> 180 W. Monte Avenue C AD 9 8 z 4 4 4 6f <br /> Rialto, CA 92316 <br /> 12. Container, ±4-0-010 <br /> 14. <br /> 11. Waste Shipping Name and DescA;tfion <br /> Total1Dnit <br /> Na Container, <br /> W1 ve1 <br /> o. NON SAZARDWS WQ19� S=D <br /> n <br /> Alf <br /> E <br /> E <br /> R <br /> 0 A z. <br /> 0 T <br /> d. <br /> G rein seriptions for Materials Listed Above f. Ffandeing Codes.!or Wastes listed Above <br /> r <br /> „ <br /> r <br /> L 1 5 cive rlondlin fn►nreNonr and Addirio ak lnf altio <br /> Oe r akppropr ate protects ve c of inq. <br /> 24'Rour EmrgoncV R96001111e{ S1T+L TO AB00 <br /> (909) 721-2038 <br /> 16.GENERATOR'S CE A mi matesiats described above oa ihls manlier,am nns orbjed to Fader re0uiatlom for ropaning wa r d,poraf of Naiordosn war*•. <br /> Ctaoth Day Yaar <br /> d/typed Nome % I u t`pa 3 <br /> T r 7,Ywnr •.is. A-4w..-le41eemanr <br /> N Printed/Typed Name Signature <br /> Manch f>e1 ser <br /> O b' <br /> s <br /> p ttf.Iransporter 1 Ael,nowledgement of xeceips of lnareriala <br /> It A <br /> Signal ro Asonrh Day Tear ' <br /> ET Primed Typed ame D <br /> R <br /> 19.Discrepancy IndkoriA Space <br /> f <br /> A <br /> C <br /> 1 <br /> 20,Facility Owner or Operator:Cerfifkarion of raceips of waits mntarials cevered by this monWast erceept as noted!rt Nem 19. <br /> T 9rinre d/Typed htemt Signature Mersh Gay Year <br /> ,rY. <br /> moi`,};"".',ll1.E. c'�.'-�;t�iJ 1"Q ri>ri-!�F'•,4if.Y' ,�, ..�� '`11:;11. <br />
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