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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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CLAREMONT
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2200 - Hazardous Waste Program
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PR0516229
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
5/19/2020 5:20:43 PM
Creation date
5/19/2020 4:49:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0516229
PE
2227
FACILITY_ID
FA0012386
FACILITY_NAME
BRANNON TIRE - CLAREMONT
STREET_NUMBER
4905
STREET_NAME
CLAREMONT
City
STOCKTON
Zip
95207
APN
10223010
CURRENT_STATUS
01
SITE_LOCATION
4905 CLAREMONT
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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4905 Claremont PR0516229 <br /> January 27, 2020 Program: HW <br /> PHOTO 15: Manifest 018526640JJK found without a designated facility signed copy. <br /> nlanln h(rowr nr, }_Frmn Appnverl OMB No 205p.00)3 <br /> >Pape-i Io,g10 0 E 4 0 <br /> L000196SJA 1 (8001)4244-9)04 �` a _ JJK - <br /> GnenliMe Sae n.rnu.r pr nnarcn <br /> EN7.BSA117 <br /> VE CA 95207 <br /> 9 477-9000 1_ <br /> U5.FPA ID Nu <br /> NMENTAL SERVICES 1 CAD028277036 <br /> —IIIA 10 Numdv <br /> US.E.PA ID Number <br /> MAddror <br /> ON IIINL <br /> E AVENUE <br /> CA 90058 CAD097030993 <br /> 77-1.500 I T�I <br /> (uxlulmg Pmpw alurpvg Namo,ItaraN C.rae�;.ID Numbar, !,oC-tlnem 1 c 12.Unn 13.Wask Coles <br /> Typy Ouanliry W1Nd. <br /> y)) <br /> RDoUS WASTE:,SOLID(BRAKE LATHE SHAVINGS) 81. <br /> DM 3OQ P <br /> Ns aaeAdeieoeal mlormaloa <br /> NTACT:CHEMTREC 1-806424-9300 WOES TERMINAL:CERES CS 'v PROFILE B 98:1:592542 BRAKE LATHE <br /> 00075727`APPROPRIATE PPE EQUIPMENT Lj. ` /X 3 D <br /> ROR'S CERTIFICATION:I hereby dedare mat in,contents of Ihm consignment are fully and—mately describedacribed above by the proper the proper shipping name,and are classified,packaged, <br /> riled,andam in an respells in proper condition for transportaccording to applc,bte intemationaland na'donal govemmental reg0labons.11 export shipment and I am the Primary <br /> memmemsolmismmgnmenlm hmmtometermsof Neattached EPAAclmoM,!dgmentof Consent. <br /> minlmizaben slalemenl identified in 40 CFR 262,27(a)(if l am a large quantity gene.ator)or(b)(Mem a small quantity,generator)I::we✓ <br /> yprd Namej" Si naNr Month Dal Year <br /> g. <br /> �-�� l� <br /> Dlmpod to U.S ❑Export from U.S. Pon o(en !exit: <br /> (Iwerpmtt Date leaving U.S.: <br /> 1.f olMalerials <br /> adName <br /> SIV�Ire -----�-- MontthDay Year <br /> YPed Name "—'�� ---"'C'—�— — `� 101c— 0:1 <br /> Signature Month Day ear <br /> kMica(ion space —1—�--�� <br /> ❑Quantity, ❑i <br /> � ❑ftesidue <br /> ❑Partial Rejectbn ❑Fult Rejed'ton <br /> Manifes— tR _—Number,_ <br /> U.S.TEPA ID Number <br /> olAllema(e Facilif� y(or Ce�ryrorJ--�,� <br /> is Waste Report Mana—emen=Meguyd Cotler--- r hazardous wage heatmen MOnU Da <br /> �� y Year <br /> ��� l disposal,and nl;rycling_ Sys —' <br /> =aalily O,meror <br /> me <br /> �dion of"oeipt o=hazy Sous mate— rlal—)b <br /> Y the manifest except as piled in—gy—�—� <br /> 913,05),Dreviou ar <br /> s obs°lef-e <br /> DESIGNATEp�I�I O_ST- �� <br /> NATION <br /> Lydia Baker, REHS Page 15 of 17 <br />
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