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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2200 - Hazardous Waste Program
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PR0516229
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
12/7/2021 12:56:39 PM
Creation date
10/8/2020 2:03:12 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0516229
PE
2227
FACILITY_ID
FA0012386
FACILITY_NAME
BRANNON TIRE - CLAREMONT
STREET_NUMBER
4905
STREET_NAME
CLAREMONT
City
STOCKTON
Zip
95207
APN
10223010
CURRENT_STATUS
02
SITE_LOCATION
4905 CLAREMONT
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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FRE MO « E- -VIRON VIEN T_AL SORVICES, INC* <br /> -Pa TD C.aR0001"101 27721 <br /> '7 <br /> F.c�. HL,� :• -. --- ~:: �.S.D.O.T.= 148466! INVOICE # <br /> 1C:1�illy. ( a=6�h -� F_� -'I �S�_t;pa D.T.S.C_ <br /> -3544 <br /> asceremoval.corn CA 274461 Date L#))-40x— /I <br /> rannon Ire BILLING/MAILING ARghnon Tire <br /> Cusco-ier _ _ — Customer_ <br /> 4905—aremon -Avenue .O. Box 1988! <br /> Stockton, CA 9 207 Stockton, CA 95201 <br /> CAL 000 1 66 538 <br /> E.P.A.- Phone <br /> Additional Contacts: Ike <br /> PRODUCT - SERVICE INFORMATION PROPER SHIPPING DESCRIPTION <br /> • _� s_ 7: - '80 - 36: W C COBE MANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT <br /> are, sK7K 73soo?E -jese -Vers NIA <br /> LAS� a 776Z bf"� <br /> -a`amckn A3ste J:T: 3f rate!Dec-- Jos CA 223 <br /> _•�/X� r"Y�2rXf :J�'� _3LE.� 3 i•Vlht <br /> 15m ti, .e-. i7ge rCA J43 <br /> NjsMie Loic. N J1 1&S-* ea 1 <br /> .::._ -=3y,< ;.x:_�a�: :., :1•:_ CA 343 <br /> n <br /> "61- 1-11140 LIFFT <br /> w•� A c�4 OA PW T <br /> 3 'c :1 c` J Y"Ic :1 55o 7 S P F <br /> :1 Cor•erotcr is rowledae C3• PPM <br /> _ c-ges;Hca;icy Tr; Cr-i-srAadito^c Labor/LAB Packing/Site Cleaning <br /> __.ze= S . _ I�OF Oily Deb <br /> SEPV'CES REi'JES'.0 3v j 3 j O TAX <br /> -_-• `' !�i'r ® P O. r TOTAL CHARGES: <br /> 77-. .a._ .a. c r. __.._ c name and cre clossified.pocked.marked.and <br /> -- _ _ : _ _-= -e -- -:age c,;an` generator.[certify that I <br /> core enc- at 1 have selected the practicable method <br /> _.... <br /> - - - - __ _-_- env.c-ra-:c Oma.it em a small quantity generator,I have made <br /> - ca•er o-e c rs•cc-c'Ora f l wetl oit from the generator Itsted above <br /> r ._.:__.___ _ -. - OR c'ac`ry,^a s•ecc rec a ccmay'wi'n Federal regulations applicable to the <br /> - __ . _ =- _-___ s'F cse has b d+scsea. S^e cus'omer agrees To pay reasonable costs and atTomey <br /> ^_`dec are��'er,enc'-i c! e=ur haT the`or in is hue and correct. <br /> 0.S°"TJ�1 �1.:w _ ,aIle-.a- ,� lar• -s. a,�;c 't_re -overnment Marine Other Induitrlal Lubrlcatlnp <br /> vtL i!•'„ t�Q i OII <br /> cp�+s�•+' CawndRuad I�fF11dhi iceG mull+ IN Be <br /> :.eaaFoes reC?tti 4L°tMM1erScree: 101 W ChadRoad 11 W6 Wilts Rock Road <br /> _ ? <br /> K. `= _ Mc 3r6cc 4 Becicia,CA%510 5 Rancho CoMore,CA 95742 <br /> .:�u.� ;, w ,•: ;?SES: }.3��M62ia 91&81 GW O0MI06 51a5t1.212ts CAL 000701439 9113351 Q980 CAD9808&1183 <br /> I <br /> Print Name GenJratoes S nata privet's Signature <br /> I here cert' t I rep an havet ori to ' i ave listed generator to the terms on the reverse side of this form <br /> 990/m 1A ODII SOAS ANH Mf1OWMA 66f1V9VVL0LT XVA LZ:9T TTOZ/ZZ/80 <br />
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