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Environmental Health - Public
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EHD Program Facility Records by Street Name
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ROTH
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2900 - Site Mitigation Program
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PR0506824
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Entry Properties
Last modified
4/7/2020 3:00:21 PM
Creation date
4/7/2020 2:49:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
WORK PLANS
RECORD_ID
PR0506824
PE
2960
FACILITY_ID
FA0007648
FACILITY_NAME
DDRW - SHARPES
STREET_NUMBER
850
Direction
E
STREET_NAME
ROTH
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19802001
CURRENT_STATUS
01
SITE_LOCATION
850 E ROTH RD BLDG S-108
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
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EHD - Public
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0 <br /> • CALIFORNIA REQUIRED ITEMS <br /> (21) Item A State Manifest Document Number: Pre-printed on <br /> Manifest. Then written on continuation sheets. <br /> (22) Item B State Generator ID: '. Leave Blank <br /> (23) Item C (Transporter 1) State Transporter ID Number <br /> (24) Item D (Transporter 1) Telephone Number <br /> (25) Item E (Transporter 2) State Transporter ID Number <br /> (26) Item F (Transporter 2) Telephone Number <br /> (27) Item G State Facility' s ID Number <br /> (28) Item H Facility Telephone Number <br /> (29) Item I Waste Number <br /> State Hazardous Waste Codes: See Table III <br /> EPA Hazardous Waste Codes - 40,CFR 261.30 - See Annex B. <br /> (30) Item J Additional Descriptions for Materials Listed Above <br /> (Item 11 a,b,c. . . ) . Enter chemical composition for each waste category. <br /> List components corresponding to the waste category entered. May include <br /> • reference to (e.g. , waste analysis number, waste disposal contract line item <br /> (CLIN #) , Contract Delivery Order Line item number, Facility Waste Product <br /> Questionnaire (WPQ) number) . <br /> (31) Item K Handling Codes for Wastes Listed on Manifest: <br /> Select appropriate code from Table IV A and Table IV B. <br /> b. Operational Procedures Manifest Preparation: <br /> (1) Generator or Generator' s Representative shall properly <br /> complete the Uniform Hazardous Waste Manifest form. Instructions are <br /> furnished on the reverse side of the TSDF copy of the manifest. They are <br /> also provided in this document. Example of completed manifest and other <br /> applicable documents are contained in Annex A. <br /> (2) Properly completed manifests are reviewed, signed, and dated <br /> by Generator or Generator' s Representative (DRMO) . Significant discrepancies <br /> are noted on each copy of the manifest prior to signature (Generator' s <br /> Certification) . Each manifest will include the Hazardous Waste Minimization <br /> Certification and a notification of restricted waste (e.g. , Notification Land <br /> Disposal Restriction with applicable treatment standards) . <br /> (3) Transporter will then sign and date (Block 17) the manifest <br /> acknowledging the receipt of the materials. <br /> • VIII-4 <br />
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