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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
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EHD - Public
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NON,IWMDDIIS 1.Gareranx ID Number 2.Page 1 of &Emergency RsWQW Phone_ 4.INUto Traotdng IMWdW -- <br /> WASTE NAWFEST CAC002957105 1 65D-331-8013 NH18061009-/r <br /> 5.GerrraWa Name end Ma.'9np Aftma Ger~*SW Addtees(N dkrwt ton mON addeea) <br /> SUMMERM LAPARTMENT COMMUNITIES. 9 ROL1W3 ROAD <br /> SMI RAMON.CA GM3 <br /> 30110 BOWTIVE PARKWAY,SUITE 460 100100ZL1N(3AME,CA 94010 <br /> Ge oo"Phos _ <br /> a.Tmnspo W l Cw"y Nrre U S.EPA ID Number <br /> 7.Tmnapater 2 Company Nemo U.S.EPA ID Number <br /> & tN&' v TS fu MEL U.S.EPA ID Number <br /> 367POTR>�t0 HLLS S LANE <br /> SUI ,CA 94585 <br /> 707-432-4E27 <br /> FodfrtVs Priam: <br /> 8.Waste SN*V Name and Deecrbdon 10'CordaYrers 11.TOW 12 Unit <br /> No, Type Ouermly WWd, <br /> 1, 1 DT 18 Y <br /> 2 ---—-- - <br /> 4. - <br /> 19$poelal HmufG IntueGons and Additional Inlom aiun <br /> 1)PHIf 1 <br /> 8-333 <br /> BILL TO: CATALYST ENVIRON ENTAL r <br /> 14.GB*RAT0R'&f0FH31GR'8 CERTIFICATIOW I hereby declare that the corterb of tfie r '::IT,r:.,!are tu'sy and:,ru,il i!dearabed above by Tia prey a Shipp.,1 name,and ae dess&Kt pad,agad, <br /> marked and labefadoocarded,and are in eA respads m proper conditbn Ior transport umirdng to upphcaDlo mwmatrerat ww rob"govwn euros. <br /> Gen ailMomes� LTA�Pnntocirryped Name Bgnldure —� • 1.1 ndr Day Year <br /> 0 FOP, <br /> 15� �ShlPme <br /> ❑Import 0 U.S. LJEvw from U.& Pat of er"ledt <br /> _Traraponer Signature(Mr a gorm or ly): DSM bffA c US.: <br /> it H Tranapater Arinorlredgm t of Paolo d Matmiala - <br /> Trangw w 1 PdrtK typed N Sgnatum MooDay Y <br /> M - /j At"i I A I � I ) <br /> Tranrpmtw 2 PtntedrTyped Me Umth Day Year <br /> 17 Dtecrr4 m-y <br /> 17a Dsc epw y Inty dm Spm ❑ ❑Type ❑Residue ❑Pmtiel Re)ectlon ❑Ful Re(edlon <br /> ', Nerieat Number: <br /> I Tb.Ah mare FedRy(or GeMator) U.B.EPA ID Number <br /> FaLkYs Phone: <br /> :af <br /> �r 17c.%ina4rre of AAerrrele FedOy(U(GerwvAor) /// MmN Day Year <br /> 18.Desi na!ed Faulty Oww or Operabr.Ce 9bilon of roc*of mebd*mored by the mon m Rem In <br /> PmnlWypedNarne MorrUr Day Year <br /> ii <br /> 169-BLC-0 6 10496(Rw 9109) DESIGNATED FACILITY TO GENERATOR <br />
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