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ARCHIVED REPORTS_XR0002422
Environmental Health - Public
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EHD Program Facility Records by Street Name
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GRANT LINE
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450
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3500 - Local Oversight Program
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PR0545201
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ARCHIVED REPORTS_XR0002422
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Entry Properties
Last modified
1/24/2020 4:29:01 PM
Creation date
1/24/2020 4:12:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002422
RECORD_ID
PR0545201
PE
3528
FACILITY_ID
FA0009068
FACILITY_NAME
Green Soap Inc
STREET_NUMBER
450
Direction
E
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
450 E GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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0lY <br /> Waste No. <br /> 916048 <br /> S - .stems TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> Generator Name [�;'i.L c [�P ?'3'� Generating Location <br /> Address 450 E. GRANT= MAD Address SAME <br /> TRA , CA 95375 SAME... <br /> TRACY, _ <br /> I?hoha'No r:. 9 L 3• i Phone Na. 0 $ 3 <br /> k: <br /> BFI Waste Codex - V S Z 3 3 C7 Containers Type <br /> Description of Waste Quantit Units No. T pe D- Drum <br /> II C-Carton � <br /> St!i lily c�i�SQV d B -Bag <br /> T -Truck <br /> 1 -7 ❑ m El P -Pounds <br /> 4 Yards <br /> El <br /> m ❑ O Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, <br /> classified and packaged, and is in proper condition for tra4portation according to applicable regulations. <br /> BOB FAQ, PLANr1:` MANAGM �- <br /> Generator Authorized Agent Name Signature Shipment Date <br /> .; TRANSPORTER <br /> Truck No. Phone No. 6 1 <br /> Transporter Name_ + '— l IZpqZ Driver Name (Print)`;-� - - <br /> Address o7 F • 7len Vehicle.License No./State <br /> Vehicle Certification <br /> E hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with, <br /> at the generator site listed above. out incident to the destination listed below. <br /> Driver Signature Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> Site Name Phone No. <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best o y nowledge the foregoing is true and accurate. <br /> ie of Authorized Agent Signature i Receipt Date <br /> PA5 CODE <br /> 10186 SF1260-72 <br /> UNLOADING AREA COPY <br />
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