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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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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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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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11/113/2008 14:49 2093312012 SJC PARKS PAGE 11/14 <br /> 11590mos Environmental Se,&,,.Akes <br /> 1515 South Rivor Rd. <br /> West Sacramento, cA 95691 <br /> (916) 371-5747 INVOICE <br /> CAD044003556 <br /> SERVICE <br /> SERVICE ORDER ORDER NO, 96293 <br /> 13ILL OF LADIN' rx <br /> DATE <br /> PAR JOB NUMBER <br /> GENERATOR PE,—CIE UROV <br /> GENERATOR EPA#C&,-0 <br /> BILLING ADDRESS <br /> GENERATOR CONTACT <br /> 1)-'NNIS AMOUNT(IF A" -kl I�1- <br /> PHONE 209-3311—W50 CHECK NUMBER <br /> 1.1793 N -------- P.O. NUMBER <br /> JOB SITE ADDRESS . MXKE GRO"IE 0, <br /> WDI CA 95240 — CASH RECEIVED (amt.) <br /> HALIDES P.P.M. <br /> J013 DESCRIPTION <br /> MATERIALS <br /> —0 COMBUSTIBLELIOU10,N.O.S-,-NA1993,til,(USED OIL) CODE fit <br /> NON RCRA HAZARDOUS WASTE, SOLID-LJQUID CODE if START TIME <br /> U.S. DOT DESCRIPTION: END TIME <br /> Ej(USEDANTI-rREEZE)NON RCAAHAZARDOUS WASTI LIQUID CODE# USED OIL FILTERS_ DRUMS <br /> MANIFEST NO. <br /> NO,OF GALLONS <br /> DRIVER'S SIGNATURE <br /> TRUCK III <br /> DESIGNATED TSDF; RAMOS ENVIRCINMENTAL SERVICES. 1515 SOUTH RIVER RD.WEST SACRAMENTO 95691 ' CAD 044003556 <br /> I HEREBY CERTIFY THAT I HAVE NOT MD(ED 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 Property classified, described, packaged, marked and are in proper condition for <br /> transportation, according to the applicable revelations of the Department of Transportation, <br /> Generator's Ceriffication.,I certify that I have-1 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 C0IIeCtPd from the generator listed above will be transported only to a facility permitted by the Stale of California to prodLICG uaed oil Into <br /> recycled oil. <br /> Terms-net 15 days. <br /> After due dare,a finance charge of 1.50%M. month,18.00l.annual rate,will be charged on the unpaid balance.The CUStOMBF aPrOOStO pay reasonable <br /> costs and attorney fees incurred in the collection of this obligation.Venue for purposes of enforcement of this obligation shall be Yolo County. <br /> .,—t declare,under p0ri*`* Penury that the foregoing is true and correct. <br /> '7 <br /> is i <br /> -4. <br /> X " - / / �' ," <br /> 4 1�� <br /> GENERATOR SIGNATURE'r. <br /> 24 Hour Emergency Response Team: I-'8' 00-456-SPI I I <br />
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