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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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W*4 AWDOUS 1.GeneretorlD Mnber2 Page 1 of &Flnerge xy Response Ptrone 4.Wage TnwWng Number <br /> WASTE MANMFEST CAC002.957105 I_ 1 I 650.331-8013 NFi18061009- <br /> 6.Generrdufs Marne and b1�5np Addose - -— LGA ftn nag Wdmss) <br /> SLR&AERHILL APARTMENT COtb14AUNMTIE9. <br /> 3000 BOMTIVE PARKWAY.SWE 450 1009 ROLLINS ROAD <br /> SAN RAMON.CA 94683 BURLIN GAME•CA 94010 <br /> Gwwawft Phar. <br /> 8.Tmmporw 1 Corrgarry Nara - <br /> U.S.EPA ID Number <br /> r ox <br /> 7.TrermpaRar 2 Calgeny Name <br /> U.S.EPA ID%mbar <br /> CT771 US.EPA ID Nanber <br /> HILLS LANE <br /> S1A9 85 <br /> 707-432.4627 <br /> F s Ptlpta: <br /> 8.Waste SNPpvrg Name and DawAftn - ---— --- 10.Carrtektara 11.Tobi 12 Lw <br /> ND. Type Quanmy WtNd. <br /> t. NOIYfi g ) 1 IXT 18 Y <br /> Z, - - --- -- - —__ — <br /> s. — <br /> a. -- — <br /> 1s <br /> *WW PtiLF ta-33 ad AdMwW Infoar,aeen — <br /> I LL.TOr. CATALYST EWRONMENTAL <br /> 14.0MERAT0R'80FR10R'6 C11i MFICATIOW I he"deoF dwd the mnunts of rhe corefgnrreM are hdly.nd r�xurataly deaw bW above by ft proper shwa name,and are dnerled,Pdap4 <br /> madaed and Wx;e l led,and are in sA nrp;cr;m props corWldon for bar)spod according to appk*A AdLuiaLo w and IN, qwmwarflane <br /> l3weWsUffomi's Prutedrl'yped Name - gilprbne • Norah Day Ypr <br /> 6) VKMA Fof� <br /> 15 krlenefional SNPIT&ds <br /> ❑lalpod to U.S. EvM 1mm U.S Port aN;*Yk* <br /> Teas orler Signature oar exrods Only}: Cable blMhq U&: <br /> CC 18 Trarr pWw AdmowWgrnw,of Roos"of MowWs -- <br /> Trarepoft 1 PdrisM)"d Nwne <br /> 8 / MorOf, Dai YM <br /> hl Ad" <br /> TrancparAar2 Nave <br /> swam Montll Day Yem <br /> 1. <br /> 17.Dwacparry <br /> 11&Dboepumy Irdestwn Sdaa ❑Queue ❑Type ❑Residue ❑Pew ReJ cw ❑Wil Relacdon <br /> MatW Rebmnoe Number. <br /> 17b.Abm to Fwltly(or Generator) U.S.EPA ID Number— <br /> Fadi ys Phone: <br /> 17o.Sl9naerm of AAsmW Fadiq(Or Genaabr) -- --N,o(l DAY Yar <br /> D <br /> 18.Designabd F Owner or owatar:C800111ftill Of MOW of mWedeb cwwW by to mandW except n nobrd in nam 17a - <br /> PdnWyped Name ) m MWdh Day Y. IIIII <br /> -- <br /> 160-BLC0 6 10498(Rev.9409) DESIGNATED FACILITY TO GENERATOR <br />
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