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COMPLIANCE INFO_2020
Environmental Health - Public
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EHD Program Facility Records by Street Name
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V
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VENTURA
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2200 - Hazardous Waste Program
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PR0537094
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COMPLIANCE INFO_2020
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Last modified
5/28/2020 4:44:47 PM
Creation date
4/23/2020 12:54:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0537094
PE
2220
FACILITY_ID
FA0020337
FACILITY_NAME
ASSOCIATED TRACTOR SERVICE INC
STREET_NUMBER
34
Direction
N
STREET_NAME
VENTURA
STREET_TYPE
AVE
City
STOCKTON
Zip
95203
APN
14504003
CURRENT_STATUS
01
SITE_LOCATION
34 N VENTURA AVE
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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i I W �R� REPUBLIC <br /> S p e c a a ste P r f i l o e 4*A SERVICES <br /> VI. Certification <br /> I hereby certify that to the best of my knowledge and belief, the information contained herein is a true, complete and accurate <br /> description of the waste material being offered for disposal and all known or suspected hazards have been disclosed.All Analytical <br /> Results/Material Safety Data Sheets submitted are truthful and complete and are representative of the waste. <br /> I further certify that by utilizing this profile, neither myself nor any other employee of the company will deliver for disposal or attempt <br /> to deliver for disposal any waste which is classified as toxic waste,hazardous waste or infectious waste, or any other waste material <br /> this facility is prohibited from accepting by law. I shall immediatelygive written notice of any change or condition pertaining to the <br /> waste not provided herein. Our company hereby agrees to fully indemnify this disposal facility against any damages resulting from this <br /> certification being inaccurate or untrue. <br /> I understand that attaching an electronic signature, I am signing this document, consent to complete this transaction and receive all <br /> related communication electronically, and agree this document will be binding as though I had physically signed it. A printout of this <br /> document may be accepted with the same authority as the original. <br /> If electronic signature is preferred,please submit completed(unsigned)form to your Special Waste Coordinator or Special Waste Sales <br /> Executive to initiate signature process. <br /> I further certify that the company has not altered the form or content of this profile sheet as provided by Republic Services. <br /> Lawrence Borelli IT System Administrator Associated Tractor Service Inc. <br /> Authorized Representative Name Title Company Name <br /> (Printed) (Printed) <br /> `d-.p r 3/11/2020 <br /> Representative Signature Date <br /> Page Associated Tractor Service Inc. contaminated soil April 2019 <br />
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