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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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NON4142ARDOUS 1.Gerem m ID Number 2.Page 1 of S Emergerq Response Phone1 1.Waste TrwWng Nuinber — — <br /> WASTE MANIFEST CA�957105 1 650331-8013 � wil$061009-),L <br /> S.Genmaloex Name and"%V Addrvu Generala'a She Addmee(ff drwwt ten malrg address) <br /> SL*AViffRHLL.APARTMENT CC&AMUNIff IES. <br /> 3000 EWCUT1VE PARKWAY,WTE 450 1009 ROLLIN S ROAD <br /> 98010 <br /> SAN RAMON.CA 94683 BLNtL.ROWNOAD <br /> , <br /> Genaramh Pharr <br /> a.Troreporter 1 Company Hama ,/► ,n ���_f ` 1 U.B.EPA ID Numbs <br /> 7.Twepo is 2 Cary Name U.B.EPA ID Numbs <br /> & �67�5p U.S,EPA ID Number <br /> bU1 I{ CA , LANE <br /> Fadn a Pfwca: 707-4324637 <br /> P.Waste Shlpparp Name and Daecrlpdon _ 10. 11.TON12 L" <br /> _ No. Type Quarday WUVOL <br /> 1 SOIL) 1 DT 18 'P <br /> 2 -- - - - - - — -- <br /> 4. <br /> 13SpelcridP,wx la-ma; <br /> -- <br /> 9LL TO: CATALYST ENVIRONMENTAL <br /> 14.ONSATORVOFFERM 6 CEATIFICATIOW I hereby dwm ew the contents of ft core'yvwnt ate lu!;y and arwrctely dearabed above I;y it;!;gaxc thppug name,and ars dassied,padeyad, <br /> marked and iabdeV0s,:wded,and are xr ah respeda in proper cowilon W k=pod acmdrog to tpplcabla urwrmwral and national gtdoecn,. <br /> Gen toy,Ufferoe3NPILdllypedNanr. Rwwdure� • t -- Month Day Yes <br /> d F0?- SU <br /> is Int order rml ❑Import to U.B. ❑Export tram U.S. Port of anhy>e,de <br /> Tram r S e lar a Delo leaMg U.S.: <br /> s 1s r aratporler Adnomledpe t of FADAt at►Meriah - <br /> Transporter l PriMed/Typed Namef t L Slum �� Mori Day Y <br /> K d 6 <br /> Transporter 2 PrinlerYfyped Name <br /> Idadh Day Year, <br /> 17.Diwcepswy <br /> I u ry Indcoon spate rOwntly <br /> ❑Type ❑aetidue ❑Panel Poswon ❑Fal B*O. <br /> aandest 110ofonco tlarnbar: <br /> I <br /> I Tb.Aerrwto FOMly(a r,enora!or) __...__ U.S.EPA ID Number <br /> Facility's Pho e <br /> 170.Signature of AlEemele Fatally(or Generabr) Monty Day Year <br /> 18.Designa$od Faedty 0wwr or 0pvalor CarlicaBoa of mol of mpapdab Meed by the mitlifasl except#_%Aged hl 4ea <br /> Prhbdrlyped Name -- '-. 6lonth Day Year <br /> 16"LG0 6 10498(Rev.9/09) DESIGNATED FACILITY TO GENERATOR <br />
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