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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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2200 - Hazardous Waste Program
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PR0518181
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
10/1/2020 3:34:55 PM
Creation date
10/1/2020 3:10:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0518181
PE
2220
FACILITY_ID
FA0003610
FACILITY_NAME
A&A GAS & FOOD MART
STREET_NUMBER
16
Direction
E
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95204
APN
13902001
CURRENT_STATUS
01
SITE_LOCATION
16 E HARDING WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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Slate of Colifornio—Environmental Protection Agency <br /> Form Approved OMB No.2050-0039(Expires 9-30-99) See Instructions on back of a 6. <br /> Please print or type. Form designed for use on elite(12-pitch)typ--iter. Department of Toxic Substances Control <br /> ,Sacramento,California <br /> UNIFORM HAZARDOUS 1. Generator's US EPA ID No. Manifest Document No. 2. Page 1 Information in the shaded areas <br /> C O D D f is not required by Federol low. <br /> of <br /> WASTE MANIFEST ` <br /> 3. Generator's Name and Mailing Address A. State Manifest Document Number. <br /> BP West Coast Products LLC 2`1 <br /> O <br /> P.O.Bax 90V7 B- State Generator's ID <br /> LO <br /> LO A. Generalors Phone (310 Y1$7-4600 Los Angeles,CA 90009 <br /> 316 ISI. IInl71n <br /> N 5. Transporter 1 Company Name 6. US EPA ID Number G Slate Transporter's ID_[Reserved.]- - <br /> D Transporter's Phone <br /> o C D 9 $ 3 S $ 4 6 $ 1 4 <br /> 7, Transporter 2 Company Name _ 8. US EPA ID Number E; State Transporter's1D Reserved.f, <br /> Transporter's Phone _ <br /> 9. Designated Facility Name and Site Address 10. US EPA ID Number G State Facility's ID _- <br /> ) Q <br /> DeMennO Kerdoon <br /> 2000 North Alameda Street H. Facility's,none <br /> Co to CA 90222 ICAT 10 $ 10 10 1113 13 15 12 (3 10)537 ?100 Y <br /> 12. Containers 13 Total 14 Unrt a w F <br /> 11. US DOT Description(including Proper Shipping Name,Hazard Class,and ID Number) to y <br /> J V No. Type Quantity Wt/Vol F Wa to Number e j <br /> Z Gasoline Mixture stat <br /> ~ 3 UNI 203 P.G.II 134= <br /> 3 G D M EPA/Otherxvs '� <br /> E .r� <br /> O N b StateE <br /> m Ea ' <br /> EPA/Other• -' 4-y`.y- <br /> A „YarsN; <br /> C.co 0 <br /> State - t yx-`Sp,{s <br /> EPA/Other' <br /> W R AM <br /> d. State 3� <br /> � <br /> W <br /> k r EPA/Other. <br /> ' J.`Additional Descriptions for Materials.L steel Above, a ;r = - K. Handling Codes for Wastes Listed Above <br /> 2000 North F�GENCYWONSEGUIDENO 128 a b <br /> O Arnm cmn•� .s,s a-, zi .t — iii u-[-s�',�{.+ c_e�"`:s. '•s^ V4 1 _•f ai. <br /> W ZheLaRNotification�rrPrrlPrlt•i�notre <br /> h HSG Gx`t�i n 25 ' 94- 4. h c <br /> 'qtr,w�2�"'"�r ,f_ <br /> ORJZ 15. Special Handling Instructions and Additional Information � ULQ <br /> 'L'IN) <br /> Gasoline and Water mime. Wear o e otective clothingARCO 4932 BEM# 39322 <br /> a �Pr' Pn� Pr sio <br /> Z (949)753-5$26(24 hoi;r Emergency Phone) 16 East Harding Way iiid P# <br /> LAB=YC <br /> F (949)45 0-1010(Mon-Fri lam to Spm) StocldonrCA b <br /> 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and-are classified,packed, <br /> Q marked,and labeled,and ore in all respects in proper condition For transport by highway according to applicable international and national government regulations. <br /> V <br /> J <br /> J IF I am a large quantity generator,I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically <br /> d practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health <br /> and the environment;OR,if I am a small quantity generator,I have made o good faith effort to minimize my waste generatipn and select the best waste management method that is <br /> available to me and that I can afford. <br /> Year <br /> T Printed/Typed Name Signature omonth <br /> _ Day O <br /> Z Larry MoothffitIBESI as agent of ARCO <br /> W <br /> Ur T 17. Transporter 1 Acknowledgement of Receipt of Materials <br /> � R <br /> W A Printed ame Signature Month Day Year <br /> W s `Gr•elte e D (� 0 <br /> P <br /> LL- 018. Transporter 2 Acknowled emenf of Recei t of Materials <br /> 0 A Printed/Typed Name Signature Month Day Year <br /> W E n <br /> V) R <br /> U 19. Discrepancy Indication Space <br /> Z_ F <br /> A <br /> C <br /> I <br /> L <br /> 1 20. Facility Owner or Q erotor Certification of receipt of hazardous materials covere4 b s man t except as noted in Item 19. <br /> Pri ted yName Signa - Month Day Year <br /> DO NOT WRITE B W THIS LINE. <br /> DISC 8022A(1/99 White: TSDF SENDS TI-I15 COPY TO DTSC WITHIN 30 DAYS. <br /> EPA 8700-22 ) Tc. ?.-0. Boz 3000, Sacramento, CA 95812 <br />
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