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COMPLIANCE INFO_2019
Environmental Health - Public
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2200 - Hazardous Waste Program
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PR0513810
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COMPLIANCE INFO_2019
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Entry Properties
Last modified
6/18/2020 2:23:12 PM
Creation date
6/18/2020 1:56:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0513810
PE
2220
FACILITY_ID
FA0003558
FACILITY_NAME
American Honda Motor Co,.Inc. Frenchcamp site.
STREET_NUMBER
123
STREET_NAME
VAL DERVIN
STREET_TYPE
PKWY
City
STOCKTON
Zip
95231
CURRENT_STATUS
01
SITE_LOCATION
123 VAL DERVIN PKWY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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BILL OF LADING/MANIFEST 1.Shipper's US EPA ID No,(If Applicable) Document Na. 2,pee 1 <br /> ? .3. . cj ofg <br /> 3.Shipper's Name and Mailing Address American Honda Motor C O. <br /> 123 Val Dervin Pkwy <br /> STOCKTON CA 95206-4001 <br /> .hipper's Phone{ 09[ -982--,r_090 <br /> ransporwr 1 Company Name 6. US EPA ID Number A.Transporter's Phone <br /> 1 <br /> 2 _2 <br /> 7.Transporter 2 Company Name a. US EPA ID Number B.Transporter's Phone <br /> CLEAN HARBORS ENVIRONMENTAL S C, INC. MAD0393R,R250 781-798-5000 <br /> 9.Designated Facility Name and Site Address W I 10. US EPA ID Number C.Facility's Phone <br /> CLEAN HARBORS OF WILMINGTON LLC <br /> 1737 EAST DENNI STREET <br /> WILMINGTON CA 90744CAD044429835 310-835-9998 <br /> 11.Shipping Name and Description 12.ContE ners 13, 14. <br /> Tl Unit H_M_1 No. Type Quart ity Wt/Vol <br /> a' UN 1`;350, AEROSOLS FLAMMABLE N. 0 S. <br /> X R. 1, UNIVERSAL WASTE—AEROSOLS DM P <br /> b. <br /> S <br /> H _ <br /> C, <br /> P <br /> P <br /> E <br /> R d <br /> 15.Special Handling Instruction and Additional Information <br /> 1) ERG#1c^.6 <br /> SK SHIP# RR5R7:.33 35 AI+MR3152 <br /> 24 HR EME�tGENCY #1-800-468-1760 ICH / SK / TFT) <br /> AUTH AS "AGENT—FOR" BY GEN TO RETAIN LICENSED SUB CARRIERS AS NECESSAR <br /> DOT/PRFL A. 7740871/1143054 B. C. D. <br /> A) NONE B) C) D) <br /> 16a.USDOTHAZARDOUSMATERIALSSHIPPER'SCERTIFfCATION: T""It toarnrrmnlrrreabo 6urndrrutlnrrdtamprgprryOa%Uko,clehod,prxagW,rngryedandlabaltd.ndare inProper <br /> xrW�tnn Mina brrilrt arinrd W rhe• ebwam or pre GO: 7 <br /> Print9dfPyped Name xoar <br /> 00 Day Y4 <br /> �` •�--� <br /> 16b.NON-REGULATED SHIPPER'S CERTIFICATION: I certify the materials described above on this form are not subject to federal regulaUnns to Transpartnilon or Disposal. <br /> Printed/Typed Name Month Day Year <br /> 7 17.Transporter 1 Acknowledgement of Receipt of Materials <br /> R <br /> A ,�ttedlTypeSl l eme Stgnalu ' Month Da Aw <br /> P <br /> fit[ t/3_�`6 v� I <br /> 0 18,Trans 2 Ackn2wledgarnant of RecaipLy Materials <br /> T PrintedlTyped Signature <br /> Month Day Year <br /> E �!! ,�e-i <br /> 19.Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I <br /> L 20.Facility Owner or Operator Certification of receipt of materials covered by this form except as noted in Item 19. <br /> I <br /> T Y <br /> Y� rinlodlTylr Name Signature rr Day rani <br /> �c <br /> 73,r"e, " Fnannnin ni_onoo1 rnar�n�a. <br />
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