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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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t <br /> NONAA2AADOl1S 1.Gwamw ID Narver 2.Page 1 of S.Fmwpxy Rsaponee Ph" 4.Mash TrooWrg Number <br /> WASTE MAMFEST CACOOM105 1 650331-8013 NHIBMI008-ti? <br /> 5.Gwwmtor5a Nmm and 64e:9n0 Aditu — — &MBWa 8%Addreba(R dMaart wan mal"eddros9) <br /> SHILL APARTMENT COML*jNITES.EXECUTIVE ECUTIVE PARKWAY,WTE 450 1004 ROL89JRIJNC3AiWJJiV9 ROAD <br /> CA 94010 <br /> SAN RAMON.CA 94588 <br /> GeneraWs Phone. <br /> 6.TmnaporW 1 CmV"Nemo <br /> U.S.EPA ID Number <br /> r7 <br /> T.Trm■parmr 2 Con"Nwrw <br /> U.S.EPA ID Number <br /> &000�5" ''yv U.S.EPA ID Nornber <br /> 367,5 QOTWO H LLB LAWS <br /> �.I <br /> &O <br /> CA 94585 <br /> 707-432-4627 <br /> F Rom: <br /> 9,Waste SNppN+lame and DesDipdon 10.Calfelners 11.TOW 12.lbdt <br /> No. Type Ourdy WLNoi. <br /> 1.. tNUNi1AZN <�lT S1U 50L1D HAZARDOUS S01L) 1 DT 18 y -- -- <br /> 2. — —- - - <br /> 4. -- <br /> 19 Special 1;Hmft Mead ana and Adttllatel Mlom #m - <br /> ALL TO: CATALYST EWIROMENTAL <br /> 14.GBlERATWV0FF =-S CEIMFICAT1011 I barely deme that the coraade of be corW7vrenl aro fully and acarately dmvd)od abase by Ito pngm ehgopdV name,and ere cluMed,pedeged, <br /> radiad and and are m u mapocts m proper cataw fa bwdport according to appkable mt",mal and naiioml r. ncin. <br /> ralO rmcwo Nnlodll'yped Name Sl nafura &9 Morr41 Day Yaw <br /> � M F0?- 5U NlF & 9 <br /> IS tnldnatwd s f t <br /> ❑ fl <br /> Import to U.S. I_I Export from U.S. Port of Ktyhdb_ <br /> T r S nature a Date w#vkN U.S.; <br /> ac 18 Trarup rter Admorvkdgmt of ReoW of M&*Ws <br /> TranrpoT - - -- <br /> rkr 1 PdrteNfyped Noma t J � ) �^✓' ,/� � �� � MaoDal' Y!�[, <br /> Tranaportnr 2 Prirledvlyped Nemo K (r J /`/ pwmm fw You <br /> 17.Drax WvKy <br /> I Ta.Discrepancy Indication Space OAntty ❑Type ❑P.K. ❑Park R*w. ❑Ful Kuala, <br /> Ftaralest Nelorerkm Numbor. <br /> 17b.Altumlo Facfly(a Ganwator) - U.S.EPA ID Nundrer <br /> Faddys Phone: <br /> 17c.Signaase of Aft mals Faoltly(or Gonealor) Month Day Year <br /> 1B. <br /> L"naiad Fw*0arwr orl0peralor:Ce�of mo*o(ualariW$cortaaed by fnau tat yCept in Item 170 <br /> P ntr N(yped Nsme A., alum Monro Day Year <br /> 16"LC-0 6 10498(Rev.9109) DESIGNATED FACILITY TO GENERATOR <br />
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