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SITE INFORMATION AND CORRESPONDENCE_FILE 1
Environmental Health - Public
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EHD Program Facility Records by Street Name
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G
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GRANT LINE
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455
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3500 - Local Oversight Program
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PR0545202
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SITE INFORMATION AND CORRESPONDENCE_FILE 1
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Entry Properties
Last modified
1/27/2020 9:47:17 AM
Creation date
1/27/2020 9:20:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
FILE 1
RECORD_ID
PR0545202
PE
3528
FACILITY_ID
FA0003124
FACILITY_NAME
7-ELEVEN INC. STORE #20304
STREET_NUMBER
455
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
455 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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I W511 <br /> to <br /> GONOrator'a Phone <br /> ho x a_ <br /> ' r <br /> 00 1 Company Ile <br /> k~ Us EPA ro N�imher <br /> v <br /> 7. Trenaporter 2 Company Name / ' TfbldBpbrt p. +` ' <br /> *,.,... - r.. <br /> $. US EPA ID Number A. <br /> 9. 4eelgnatadFecility IFa end Site Address F TPt�E6Aprte�8 Phpne - <br /> !1 L�11 lb 7�/] r 10. US EPA ID Number O 8htta FaC r T <br /> �AE0 cf— <br /> . Icy s la r <br /> .r:.. <br /> r`i a CA nl ` H. FACM }` <br /> & ISL C-� qv/.�-- _ <br /> I J 11. US DOT peacription(including Proper Shipping Name,Hazard Claes,and ID Number) `12, C6ntainers 13. Total 14. <br /> Quantity Unit r `G';; <br /> Type Weete iva., <br /> � t3 State <br /> log �e, <br /> f b. t.F+r ._Q•.e�l 0..Qw. .'" _ <br /> F V s <br /> A A, <br /> N 0 1 R C <br /> R I V E D tlt,Other. <br /> e c. r <br /> JUN 0 6 1989 state <br /> .1PA! T <br /> W d. _ I <br /> • ' V� am x <br /> i <br /> U � <br /> EPKI <br /> w <br /> to <br /> tins tdf Mtit[llNalif�Idted Adove_ - - - <br /> s <br /> (n wt z,F "" ,� �a t a4, t^..a",� 't•. mk. W:S rte,. 5 F <br /> Q <br /> .Z <br /> t nq hYetructFone and Additional IMormatloflr <br /> yw ' <br /> F Y <br /> t <br /> GeNERArOR's CRfflVfr.ATWW. I herstly ded'aya gist t1Ra doritente of hila conalgnmee :ar fullyF end'eccuratery described abrnie by propg'r ahi i' <br /> and ars classified,Packed,marked,ariff-tebeied;8114 eta 111 all respects in proper can dNi�t to1°tran PP nG name. . <br /> national government ragutations: sport by highway according to applicable international and <br /> It I am a Iaige'quenfityy generator,I din!rllays a Pibgritin in place to"redkice the vot'lmie and.toxtcitj!of waste <br /> to be economFcapy Practicable and that I tittVfs eeleded the Generated to the degree k Neve determined <br /> pr6cticabla method of treatment;storage,or'dlepoeel-currently available to me which minimizes the <br /> _ <br /> present arid'talars throat tC'Ititrman IieaiM aliR d1e advlronmeM;OR,If I ain a smell quantity generator,i have made a good faith effort to minimize my waste <br /> Generation and aelecR the,.661I wade msrisdiMeM'1711 thaT Is available to meand that Ican ajiI <br /> LUz <br /> PrinI:1 Nanta <br /> w L f it r�t� Gn Y✓- kfdn�Day Year <br /> _. _. _ ...._ _.n <br /> y � <br /> W RT ,1 rensporter 1 Acknowt+adg76draM•of Receipt'of IiRdteri6ltr � <br /> _, - <br /> C. + ted/TYped'Name- - - <br /> LL Alon 7Day r� 4 <br /> W p 18:.Transporter 2 AcknoWledpointard,of Retieipt of Ildsiertald - arl' t <br /> 1 I a T PrfMedlTyped%rrw <br /> Z <br /> a Signature ATOM Day Year <br /> 18: Discrepancy indication Space - { <br /> F I <br /> A <br /> C <br /> I <br /> L <br /> I' 20. Facility Owner or Operatorificatton° eipt t h rebus'materiels covered by this menMeat'e ea not he <br /> T <br /> Y Printed/ ams Signature 01 M Day Yea I <br /> Elis 8720 a(1 tam Not Write Below This L <br /> EPA 8700-22 Yellow:TSDF S COPY 0 GENE RATOR WITHI 30 DAYS <br />(Rev.9.88)Previous editions are obaolefa: <br /> IL <br /> f <br />
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