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CO0047142
Environmental Health - Public
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2200 - Hazardous Waste Program
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CO0047142
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Entry Properties
Last modified
9/14/2020 6:28:05 PM
Creation date
9/14/2020 9:19:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
RECORD_ID
CO0047142
PE
2200
STREET_NUMBER
23523
Direction
S
STREET_NAME
BANTA
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
25013009
ENTERED_DATE
7/24/2018 12:00:00 AM
SITE_LOCATION
23523 S BANTA RD
RECEIVED_DATE
7/23/2018 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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ADMIN
Tags
EHD - Public
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NON-IIAZAltDOUS 1.Ganewror 10 Number 2.Page 1 of S.Emergency Response Phare 4.Wn%Tr=Wng Rwdw <br /> WASTE MARFEST CAC002957105 1 650^331-8013 009-'T,, <br /> 5-Gerwitols Name wf MOM Address - GeneraWs Brie Adc4eaa(R dllaelY then me�rnp addnes9) <br /> Si h*AEFNLLAPARTWENT COMMUNITIES. 00 <br /> 19 ROLLNUB ROAD <br /> 3000 EXECUTIVE PARKWAY,9LdTE 450 1 19 RIGAME,CA 940f 0 <br /> SAN RADION.CA 94883 <br /> Gemeratnrd Phar +m <br /> S.TMMPMaer 1N l U.S.EPA ID Number <br /> `l� 7 r 9 V^i t C <br /> 7.Traespoder 2 Company Name US EPA ID Number <br /> U.&EPA ID Nombur <br /> �C <br /> 94585 LAME <br /> 707-432-46x7 <br /> F a Phone: 1 <br /> --- — --- —— <br /> D.Wavle SNppi>g Name and Deecripdvn <br /> 18.CorlteNers 11.Toed 12 lhdt <br /> No. Type oub'dy WUVd. <br /> t. iN0' LT5 WASTE (141JIIF'HA7�4Rp0U5$f?Y) I DT 18 Y <br /> 4. <br /> 13 SpecW Flendirg krdvodom wd Addearer InfomWon <br /> 1)RILF is-333 <br /> N.L TO: CATALYST ENVIRONMENT& <br /> 14.OENERATOR'fIOFFEFtOR16 COMFICAMOW I hereby dulare thel fro caMarb d eye consig mail are fullyand.r,*ly desc:obed Above try Iho proper shipping name,and we daseded,pad sgK <br /> marked and labelodwwded,and are m es reapecis in%prosper eondltlon for bxwpod somrdng to oppbceble aftwim oral and nabaud gwwm 9 aaans. <br /> GenegsWaRMroro Pri�odyl'yprd NnrrM �� I Stanalure/,/ 9 � - � � � No,* Day I Year <br /> lwfs <br /> IS klemidonal atmem ❑I"M U.S. El Evw from U.S. Port 01 enitylmdt._ <br /> Tran dor S nature kx ovaft Date IMM U.S.: <br /> w 1e Transporter Adnowledgrnsm of RecW of Mtlelige <br /> Transporter 1 Rlreedllyped Nano SWAMMOM fay y" <br /> -- — <br /> Transprafm 2 Nn•Wyped Name Slyrpajrg Month Day Yew <br /> 17.Dwreparicy <br /> i7a Discrepancy lmkdm Space <br /> ❑Type ❑Resldtre ❑Panel Flelecdon ❑Ful Rgectlan <br /> mamfe^�t Reloronco Number. <br /> 170.ARamaa POW(or Gar*mtW U.S.EPA ID Number <br /> FadWs Phone: !/y <br /> J. 17r.SkjnAue of Anemafe Faclky(or Gorw& r) Month Day Year' <br /> o \`rA�/ytiry��oa7 <br /> 18.Uesignolnd Faahty Oester or Owalor.Cert ticN on of receipt of ffaWele covered by the mann ; in)lam 17a <br /> Pmtedriyped Nerve -- -- Mm* [ay Year <br /> 16"LC-06 10498(Roy.9x08) DESIGNATED FACIUTY TO GENERATOR <br />
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