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COMPLIANCE INFO_2010
Environmental Health - Public
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2200 - Hazardous Waste Program
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PR0514166
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COMPLIANCE INFO_2010
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Last modified
6/23/2020 3:32:03 PM
Creation date
6/23/2020 1:36:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2010
RECORD_ID
PR0514166
PE
2220
FACILITY_ID
FA0010096
FACILITY_NAME
BROOKSIDE GOLF & COUNTRY CLUB
STREET_NUMBER
3131
STREET_NAME
BROOKSIDE
STREET_TYPE
RD
City
STOCKTON
Zip
95219
APN
11811036
CURRENT_STATUS
01
SITE_LOCATION
3131 BROOKSIDE RD
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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AMERICAN VALLEY 156164 <br /> WASTE OIL, INC. Invoice Number: <br /> P.O. Box 340 - Delhi, CA 95��3gg1gg5��3 <br /> PH. 1-80 EPA`f�MCARW 9,.302 <br /> BROOKSIDE COUNTRY CLUB BROOKEIDE COUNTRY CLUB G 12 <br /> BUI TO: 3W3 ST.ANCREWS OR )OB SITE: 3131 B RO`JKSIDE RD, <br /> STOCKTON.CA 95219 Invoice Date: <br /> GL,4vE ETES JS 119 <br /> X: MARCH LANE <br /> Sa-s Rep Felix <br /> Phon 7 Customer P.O. TKIT191et30 Days EPACAL0002U,54,37 <br /> PRODUCT SHIPPING DESCRIPTION WASTE MANIFEST QUANTITY PRICE AMOUNT <br /> CODE <br /> NON-RCRA Waste Liquid Used OiVMixed Oils 221 I ,. <br /> NON-RCRA Waste Liquid Used Antifreeze 133 <br /> NON-RCRA Waste Liquid Used Oily Water 233 <br /> Drained Used Oil Filters <br /> IJ <br /> Sales Tax <br /> TERMS: Invoices over 30 Days are subject t0 a 1.5%service charge. Customer agrees t0 pay all legal fees it court action TOTAL <br /> gecomas necessary to collect this invoice. <br /> By signfnp I herby artily that I have not mixed any of the waste described above with any other hazardous Waste,the total halide content Is LESS than 1.000 Ppm.and the <br /> waste does riot contain any PCBs.I have compiled with the requirements of the applicable California used oil management regulation to determine this is true.I agree to <br /> accept the additional charges for ttw disposal of this waste It the information I have provided about this waste is Incorrect. <br /> Generator's Certification:By signing 1 certify that if 1 am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste gerwat- <br /> ed to the degree I have determined to be economically affordable and that 1 have selected the practicable method of treatment,storage,or disposal currently available to me <br /> which minimizes the present end future threat to human life and the environment:Or,if I am a small quantity generator,I have made a Good fa th effort to minimize my waste <br /> generation and seieot the waste management method that is avallable to me that i can afford. <br /> Arnerrican Valley Waste 011 hereby advises lite above Generator that generators shipment of used oil may be transported to a facility that Is required to comply with federal <br /> regulations appticabie to marn&gement of used off,but that Is not required to comply with the more stringent requirements apphcabla to hazardous waste management facill- <br /> tee Califon,&facilities that handle or process used oil are required to meet those more stringent requirement,and some out-of-state facilities that process used oil also rnaet <br /> those%qulroments,engineering oenftations of tank integrity,and finenclal assurances for closure and accidental releases.It is lawful to send used 00 to out of state t"It ea <br /> that oompty only with federal used oil management starWards and not these more stringent requirements. <br /> This notWcaticn is for information purposes oW <br /> By both parties signing this Invoice it will serve as an agreement that Amerlcan Valley Waste ON will submit confirmation for(certain waste streams)to the generator that their <br /> waste has boon transported to a licensed treatment or transfer facility. <br /> GENERATOR! <br /> DRIVER Fo AUTHORIZED <br /> SIGNAT E DATE- VZ <br /> SIGNATURE: W14�2e__DAT <br /> DK-DIXON O ASBURY ENVIRONMENTAL O RIVERBANK OIL TRANSFER O CFR O GLOBAL MATERIAL MGMT <br /> 7300 CHEVRON WAY 1920 MORGAN RD. 6300 CLAUS RO. 2035 E. 15TH ST. 1640 N.BROADWAY <br /> DIXON,CA 95620 CERES.CA 95358 RIVERBANK, CA95367 LA,CA 90021 STOCKTON,CA 95205 <br /> 707-693-6008 707-893-8008 209-863-8181 213-746-0237 818-770-2577 <br /> EPA#CAT080012602 EPA#CAL000393680 EPA#CAL000190816 EPA#CAL000270577 EPA#CAL000417316 <br /> MPC(72016) <br />
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