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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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NON4IAZARDDl18 1.Generator Ie w nber 2.Page 1 of 5 Emarp W Reaporos Pku 4.Nub Tractlnp Number <br /> WASTE MANIFEST <br /> GACA02957106 1 65e`331-8013 NFi18061009-��;' <br /> S.Gerwim fa Name and MRAV Addlrw - — Generator's tale Addreae(R dYMrr N Own nWg eddrsss) <br /> SL II.LAPARTMENT COMbUJUTIES. <br /> 3000 E)taCI.ITIVE PARKWAY,SUfTE 450 1009 ROLLNVS ROAD <br /> SAN RAMON.CA 94683 13URUNGAME,CA 44010 <br /> Generuor'a Fhone. _ <br /> 8.TraropoAm 1 Conpvy flours U.S.FPA ID Number <br /> 7.Tmwporbr 2 Comprny Narw U.9.EPA ID Number <br /> &D-0 U.S.EPA ID Nomber <br /> � <br /> CA W55 <br /> 707-432-4627 <br /> FacNi a Phone: <br /> 8,Waste Sfdgxg Name and Daecrtptlon <br /> 10.Containers 11.TOW 12 Unil <br /> No. Type Qua* WLIVd. <br /> t. ItlON-Ii�ZARLIQIJS TE ) 1 DT 16 Y <br /> tD 3. — <br /> 4. <br /> I <br /> 13 SpecW end 18�dom end Aditone <br /> BIL TCr CATALYST ENVIRONMENTAL <br /> 14.f1�fERATOR'SlOPFEROR'6 CFATIFICATl011:I horaDy deelare that the coMarb d Qne wr>r:yvr,p,l era fully end rxuualuly deac.�ed ebove by fly twat t::sh�pPnB name,and are rlasa8ad,paaepeq <br /> martoad and WmiadVOcarded,and are In al mapecls m laoper cww ition lar transport acco dng to uppbcaw urtorrannal rnrl raiatel yvrw aucn•, <br /> Gcnclo("aroes Fnnlod/fyped Name S'nalure . <br /> kj -- i i i <br /> ❑ onar Day Y4W <br /> 15 InMrurtionel Shipments -- <br /> Impod m U.S.U.9. ❑EKpod from U.S. Portal snlrylerdt:_ <br /> Trans ell Spanalul(for egArts Dalo loavin9 U.S.: <br /> a 16 Trer"oft AshrmW prem of Realp of►lekriaia <br /> Trarreporler 1 PdntedaWed Name / Sigr>alure \ MOM Day YW <br /> ivjVkQA <br /> TMsporbr 2 Prfniedr ww Nerve $l� Mandy Day Yaer <br /> 17.Daragranay — <br /> 17e gscrepanry Indadal Space ❑Type ❑fielfdue ❑Partlal Re)adion ❑Fw w. <br /> MarMkst Hofererrce Number. <br /> 170.Attcmam Fadlly(or Garreralor) U.S.EPA ID Nmnber <br /> F s Phone: <br /> 170.Soulum of Mamie Fad1Ry(or Generator) — �� Mmth Day Year <br /> yell <br /> 18.De*ria id Fao*0emer or OpsivV:CerlinDon d new of male wo wwW by the mendeet except u tknr 4fia, �� <br /> Fht rtfxYiyped Nnme 9lpraabrre l- -- -- Month Day Year <br /> I6"LC-0 6 1049B Mov.WN) DESIGNATED FACILITY TO GENERATOR <br />
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