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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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NON4IAZARDOUS 1.Generetari0 Number 2.Page t or a EntejwV RWnse Phm 4.wane Trackingmb <br /> Nuer <br /> FEST _ <br /> WASTE UAMCAC043957106 I 1 ( 65D-331-8013 NHIO 610094 - <br /> 5.Gat nWe Name and Ma'9rtg Addtasa Gcmrators Ru Address(d dithrarrl harm mdhp,beau) - <br /> SUN&t1ERHU APARTMENT COMMUNTIES. 1009 ROLINVS ROAD <br /> -VW BOXTiVE PARKWAY,SUITE 4SO 1009 tOLL1 CA D 0 <br /> SAM RM40N,CA 9M3 <br /> Generator's Phare. IIZ----. _ <br /> 6.Trensponer 1 Cornpmry Nam U&EPA ID Number <br /> 7.rrarpaAar 2 Canpany Hama U.S.EPA ID NumzR — <br /> & � ±� U.S.EPA ID Number <br /> SSLRIN ROH LAME <br /> 707-432-4677 <br /> Fsa s Phono: <br /> 9.YkO Shipp%Name and Deeatpllon 10.COntallm 11.Told 12 Unit - <br /> No. Typa Ouarttiry wwal. <br /> 1 DT 18 Y <br /> m <br /> um 2 <br /> m <br /> i <br /> i <br /> 4. <br /> 13 Spj i Pl'ILFl� and kkfford Inroormdcn — — -- -- - - <br /> MJ-TO' CATALYST EWROA MENTAL <br /> 14.OBIERATOR110HE tDF1'6 CERTIFICATION*I dedi:e iho the coa.i n N drn comm ,-rant are fu and aowralal deac�ed above the r eh name,and am daaaAecL <br /> hereby m, �' Y by W� �n9 PacYa9e4 <br /> martoed and WWtdlplacarded,and are in 0 respects m proper catdrLon for bartspart a=dng to appkcla etlamelm:a]and rmboraf gave aecas. <br /> Gene t"[ me mes PrintedrTyped NaSfgnatunF • WrAh Day Ycar <br /> fb?l <br /> 15 Irttcrrtcdfonn!SMprrents ----- -- <br /> ❑lmpod to U.S. ❑ErpM from U.S. Portal rurlrykxN: t <br /> TardMer Sigrolurs for exports Drill: Deb boVirtg U.S.: <br /> Cc 16 Tramporler Adnmvts 7rwd of Raceiof of Materiels <br /> Tranrporler 1 Pdtte nWed Norma �Ur ' Sl�tthrre -- - Month Day Year I <br /> V eco S 1 �l&� M 11 <br /> Trenepader 2 PrinlWyped Name 1 Ntla6 -- — A1`ontth yow <br /> 17.Diarepnay <br /> I Ta.Discrepancy Irdcadon Space <br /> ❑ Type ❑Rwww ❑Parw AeJ ww ❑Ful Re)edlon <br /> Mandest Fictareace Number. <br /> 17b.Altur ate Fectfty(or(34norator) U.S.EPA ID Number <br /> Facility's Phone: <br /> 17C Sfgtafure 01 At smehe Fadlty(or Go te^dlor) Month Day Year <br /> y <br /> A, <br /> 16.Designated FOG*t]rrter or gwralor:Certil aft of receipt of malerifft wood by tlta raanlest ex flan 170 --- -- <br /> Pmted Typed Nam ------ — Month Day Year <br /> 169-BLC-0 8 10498(Rev.9108) DESIGNATED FACILITY TO GENERATOR <br />
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