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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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MICKE GROVE
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11793
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2200 - Hazardous Waste Program
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PR0514036
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COMPLIANCE INFO
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Entry Properties
Last modified
6/30/2020 5:52:10 PM
Creation date
6/23/2020 6:24:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0514036
PE
2220
FACILITY_ID
FA0000287
FACILITY_NAME
SJC MICKE GROVE PARK
STREET_NUMBER
11793
Direction
N
STREET_NAME
MICKE GROVE
STREET_TYPE
RD
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
11793 N MICKE GROVE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\HW\HW_2220_PR0514036_11793 N MICKE GROVE_.tif
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EHD - Public
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os Environmental Servi�s <br /> 1515 South River Rd. <br /> West Sacramento, CA 95691 <br /> (916) 371-5747 INVOICE # <br /> CAD044003556 <br /> SERVICE• <br /> SERVICE ORDER ORDER NO. 96293 <br /> BILL OF LADING <br /> DATE � '� -, `. <br /> M:.CK Gitt)Vh' FARK JOB NUMBER <br /> GENERATOR GENERATOR EPA#(:41. COO IfJ;Z <br /> BILLING ADDRESS <br /> AMOUNT(IF ANY) <br /> GENERATOR CONTACT CHECK NUMBER <br /> PHONE 01 °-.3.5)__;' � 't <br /> P.O. NUMBER <br /> JOB SITE ADDRESS 11793 ?1. M ("KE GR0VE RD. CASH RECEIVED <br /> l.l�D! 0A 95124 ) (amt.) <br /> HALIDES P.P.M. <br /> JOB DESCRIPTION __-?_1' t <br /> ' 045"S- <br /> MATERIALS__ <br /> •0`COMBuSTIBLE`LI0U1D,N0S_, <br /> -NA1993,III, (USED OIL) CODE# <br /> F] NON RCRA HAZARDOUS WASTE. SOLID-LIQUID CODE# START TIME <br /> U.S.DOT DESCRIPTION: END TIME <br /> (USED ANTI-FREEZE)NON RCRA HAZARDOUS WASTE LIQUID CODE# USED OIL FILTERS , DRUMS <br /> MANIFEST NO. } NO.OF GALLONS <br /> DRIVER'S SIGNATURE TRUCK# ( { <br /> DESIGNATED TSDF: RAMOS ENVIRONMENTAL SERVICES. 1515 SOUTH RIVER RD.WEST SACRAMENTO 95691 CAD 044003556 <br /> 1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY OTHER WASTE,AND THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M. <br /> This is to certify that the above named articles are properly classified, described, packaged, marked and are in proper condition for <br /> transportation, according to the applicable regulations of the Department of Transportation. <br /> Generator's Certification:I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined <br /> to be economically practicable_Ramos agrees with the generator to send all their hazardous waste to an authorized hazardous waste treatment facility <br /> via Ramos'standardized permitted storage facility. <br /> All used oil collected from the generator listed above will be transported only to a facility permitted by the State of California to produce used oil into <br /> recycled oil. <br /> Terms-net 15 days. <br /> After due date,a finance charge of 1.50%per month,18.00%annual rate,will be charged on the unpaid balance.The customer agrees to pay reasonable <br /> 0osts and attorney fees incurred in the collection of this obligation.Venue for purposes of enforcement of this obligation shall be Yolo County. <br /> declare,under penafty'of perjury that the foregoing is true and correct. <br /> GENERATOR SIGNATURE <br /> 24 Hour Emergency Response Team: 1-800-456-SPII <br />
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