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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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T <br /> NONHAZARDOUS I t.Generals 10 Millibar 2 Page 1 of 9 Emergency Fbaponee Phone 4.Wants TraoYing Number <br /> WASTE MANIFEST CAC002967105 1 65x331-8x13 NH18O61009-4 <br /> 6.Generator's Name and Ma:lrfp Aedreas GenerEW3 Stle Address(a dltlererd Can atWkg address) <br /> SI.1L&ERHI LAPARTMENT COMMUNITIES. ia49 Roc mus Raw <br /> 3000 EXECUTIVE PARKWAY,SUITE 45o 109 RO LW CA. Seel a <br /> SAN RAMON.CA eases <br /> Generators Phone. 415-294-MOT <br /> _ <br /> S.Tmmpo(la 1 Cmr�ary Nemo U.S.EPA ID Number <br /> 1 y L Wil. 6� <br /> 7.Trerrpo tm 2 Qompmty Name U.S.EPA ID f ffw <br /> 3�71Qan,C ot41 ase U.S.EPA ID Nomber <br /> lsiJ1r9d585 <br /> 707-432.467 <br /> F s Phone: <br /> 8.Waste Shipping flame and 0escr'prlon <br /> 10.Comakrers 11.Total 12 LIM <br /> No. Type Quwtty wwa. <br /> 1. NO E SOIL) 1 DT 1$ Y ---—_.---- <br /> 4. <br /> 13 Special Hanclilry IfKv cdona and AdMonol Inbmavon <br /> 1)PH!F 83.33 <br /> KL T8: CATALYST EMMi0NIv1ENTAL <br /> 14,0fiNMT0A'&VFMM1S COPFICATIOW I hereby declare that ft content of ft erm[grrn i are 1uAj end avxufataly dewAed above by tho proper shgrp V name,and ars dassied,pecl aped, <br /> marred and c,bv>♦edf warded,and are In d mepects m proper caditfon for w.mspod u=dng to eppkabfo marrcdrnsl slid nabonal qovvmmj^w4pqkvw& <br /> Gm demes Prmlklfryped Name _ S grnturo . Mor*v Day Ym <br /> i.i fflifs JV <br /> 15 Intemalionel Shipments <br /> Impar to U.S. ❑EOM from U.S. Port a1 eMty/adt: <br /> Tierra tee SigaArs floc a ds oriy): Dale barba U.S.; <br /> w 16 Tmmporaer Admauledpmerrt of faeoelpl of INftos ---- -- <br /> 7M6F1 �°Nam-- -70'-2 -, sfgrowre -- - - Mann Des Yen <br /> Tref mIw 2 PrmeA'Typec'Meme Sign re Day year <br /> n.piecreparfcy - ---- <br /> 17a a�cmp:a,�y IrrrAmtlm Spxa ❑CUM" - ❑Type ❑Resk4ne ❑Partial Relaetiral ❑RN I*l«f <br /> My ic-31 flclowco Numbar. <br /> 17b.AUnate FoclNty(or Generator) -- — -- U.S.EPA ID Number <br /> Feer Ws Poon: <br /> 170.SO-dure of AADM*Fadky(or Generdbr) Month Day You <br /> Deeignaled Fac!!y Omer or .Certlli0atbn of incept of=W*wmad by dm taan*W except m noted in fleet 179 <br /> PrtntacYTyNd Name Slpfahnro Nanth Day <br /> 1WBLC-08 10498(Rev.WN) DESIGNATED FACILITY TO GENERATOR <br />
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