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COMPLIANCE INFO_2019
Environmental Health - Public
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2200 - Hazardous Waste Program
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PR0541165
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COMPLIANCE INFO_2019
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Entry Properties
Last modified
8/6/2020 4:33:10 PM
Creation date
8/6/2020 4:28:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2019
RECORD_ID
PR0541165
PE
2220
FACILITY_ID
FA0013585
FACILITY_NAME
KUSTOM MATERIALS LAMINATORS
STREET_NUMBER
619
STREET_NAME
GILLIS
STREET_TYPE
AVE
City
STOCKTON
Zip
95203
APN
16203007
CURRENT_STATUS
01
SITE_LOCATION
619 GILLIS AVE
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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AMERICAN VALLEY <br />WASTE OIL, INC. <br />Im'tlicc Number: <br />P. O. Box 34d •Delhi, CA 95315 <br />PH, 1-800-732.4645 FAX 209.669W6`'�I000416714 <br />'ti't��4�090837�'14 KUSTOM MATERIAL LAMINATORS <br />KUSTOM MATERIAL LAMINATORS 619 GILLIS <br />619 GILLIS STOCKTON, CA 950206 _ r .._-._- <br />B11,1. TO: STOCKTON, CA 96020 JOB SITE: Invoice Date: <br />Customer P.O. <br />PRODUCT SHIPPING DESCRIPTION <br />WASTE <br />CODE <br />NON-RCRA Waste Liquid Used Oil/Mixed Oils <br />221 <br />NON-RCRA Waste Liquid Used Antifreeze <br />Sates Rep: <br />MANIFEST jOUANTITY PRICE AMOUNT <br />^li l �l <br />-- <br />133 <br />NON-RCRA Waste Liquid Used Oily Water j 223 <br />Drained Used Oil Filters <br />-$tt COLLECTION FEE --- — — I--- -- <br />TERNIS: Invoices over 30 Days are subject to a 1,55o service charge. Customer agrees to pay all legal lees it court action TOTAL <br />becomes necessary to collect this invoice, r ( 1+ <br />6y signing I herby cel ti(y that I have not n•J<ecf any of the waste describer', above v.•ith any other hatardous waste, the Intal halnlc content is LEST than 1,0CG ppm, <br />antTthe waste docs not contain any ?CR+. I have complied with the requirements of the applicable California used oil management regulation to <br />Generator'. Certification: By signing t certify that it I am a large quantity generator, I cr•+tify that I have• a program in place to reduce• lite volume andtoxicity of <br />waste <br />Jetennine this r: <br />true. I agree tc accept the <br />a ul charges for <br />the disposal of chi[. waste iT the infonnalion I have provided <br />about th s waste is incorrect. <br />availahle to mn which minimims the present and <br />luture threat <br />to hurnan hfe and the erwironmentI Or, <br />J I am a small quantity generator, 1 have made a gond faith <br />effort to rninimite my waste generation and select the wast• management nmthexf <br />that is available to <br />me that I can afford. <br />Sales <br />Tax <br />TERNIS: Invoices over 30 Days are subject to a 1,55o service charge. Customer agrees to pay all legal lees it court action TOTAL <br />becomes necessary to collect this invoice, r ( 1+ <br />6y signing I herby cel ti(y that I have not n•J<ecf any of the waste describer', above v.•ith any other hatardous waste, the Intal halnlc content is LEST than 1,0CG ppm, <br />antTthe waste docs not contain any ?CR+. I have complied with the requirements of the applicable California used oil management regulation to <br />Generator'. Certification: By signing t certify that it I am a large quantity generator, I cr•+tify that I have• a program in place to reduce• lite volume andtoxicity of <br />waste <br />Jetennine this r: <br />true. I agree tc accept the <br />a ul charges for <br />the disposal of chi[. waste iT the infonnalion I have provided <br />about th s waste is incorrect. <br />Ry both parties signing this Invoice rt will serve as an agremunt that Am;ncan Valley Waste Oil will submit confirmation for (certain waste streams) to the genewtur <br />that thea waste has Lt:en transported to a I�ccnsed treatment or transfer Lrcility. <br />GENERATOR' <br />DRIVER J AUTHORIZED DATE: <br />SIGNATURE �h- DASIGNATURETE. I Z'S/!6 —1 <br />ISPO AL RECYCLING FACILITY <br />DK-DIXON O CFR O UNITED ENTERPRISES CORP <br />7300 CHEVnON WAY 2035 F. ISTH ST 11190 PEIJROSE ST. <br />DIXON, CA 95620 LA. CA 90021 SUN VALLEY. CA 91352 <br />707.693.6008 213-745-0237 818.787-2649 <br />Il CAT060012602 EPA( CAL000270577 EPAd CAL000379059 <br />r <br />APR 0 t5 2019 <br />ENVIRONMEf14TAL HEALTH <br />DEP/�RTlVIEC'�1T <br />waste <br />generated to the degree 1 have determined [a be <br />ecoromicalty <br />aflordabie and that <br />I have selected l'ne <br />practicable method of treatment, storage, a dbposaf curn>ntty <br />availahle to mn which minimims the present and <br />luture threat <br />to hurnan hfe and the erwironmentI Or, <br />J I am a small quantity generator, 1 have made a gond faith <br />effort to rninimite my waste generation and select the wast• management nmthexf <br />that is available to <br />me that I can afford. <br />Ry both parties signing this Invoice rt will serve as an agremunt that Am;ncan Valley Waste Oil will submit confirmation for (certain waste streams) to the genewtur <br />that thea waste has Lt:en transported to a I�ccnsed treatment or transfer Lrcility. <br />GENERATOR' <br />DRIVER J AUTHORIZED DATE: <br />SIGNATURE �h- DASIGNATURETE. I Z'S/!6 —1 <br />ISPO AL RECYCLING FACILITY <br />DK-DIXON O CFR O UNITED ENTERPRISES CORP <br />7300 CHEVnON WAY 2035 F. ISTH ST 11190 PEIJROSE ST. <br />DIXON, CA 95620 LA. CA 90021 SUN VALLEY. CA 91352 <br />707.693.6008 213-745-0237 818.787-2649 <br />Il CAT060012602 EPA( CAL000270577 EPAd CAL000379059 <br />r <br />APR 0 t5 2019 <br />ENVIRONMEf14TAL HEALTH <br />DEP/�RTlVIEC'�1T <br />
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