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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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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-NIOU ' E' -VIRONMENTAL SCIRVICES, INC. <br /> n- P.rr;.en; :I P7ore. S C-;9-= - -> EPA ID=C.�R0001'3017 n <br /> P.O. Bm :-s-: ?hone. (;.S.D.O.T.= 148466- INVOICE # <br /> Vaca-611t. Ca 95696-28 Fay 48-3499 D.T.S.C.=3544 <br /> N,;-%;w,haz s•asteremo%al.cotn CA-274461 Date 2.22 �l <br /> S!TE ADDRESS BILLING/MAILING ADDRESS <br /> Customer Rmnnnn Tim Customer Rrannnn I ire <br /> 49055 Claremont Avenue N.10. Bax 1988 <br /> Stockton. 0 9 2J% Stockton, CA 95201 <br /> E.P.A. i3 f-'A 1 000 1 <br /> 06 Phone <br /> Additional Contacts: 209 4/ 7-900 <br /> k lo <br /> PRODUCT • ERVICE INFORMATION PROPER SHIPPING DESCRIPTION <br /> • 2" 3: s5 6 90 180 365 W•C WASTE I MANIFEST NUMBER QUANTITY UNITS PRICE AMOUNT <br /> CODE <br /> Gallons N �S <br /> -rc ;: _o, - - - i sd Gailons <br /> 55.00 <br /> --- 'i r_ - Com- �� CA LCJ <br /> 7 2 Z .S rr?S Cry 312 <br /> ce Re^-•cve # A: 'A2 5g ❑ '.0g ❑ 15g ❑ 30g ❑ 55g ❑ S P F <br /> C•o• -,o`- ^4:0�'es' C'-: "es- ass ❑ Faf ❑ Gererator Knowledge Q-'QPM <br /> Ac30`Iaa1 T ick Time/Additional Labor/LAB Packing/Site Cleaning <br /> Clea: ! _abets Oily• �� - ` A/F UOF_,,`i o if L Oily Debris ops Z <br /> SERVICES REQUESTED BY TAX 00 <br /> Ac-cep, .� P. O. TOTAL CHARGES: <br /> GENERA'Ot S CERrc.Co^ar: and are classified.packed.marked,and <br /> om a forge quantity generator.I certify that I <br /> =_ ne ec:c%-ice!iv p'ccGcob:e and thc1l hove selected the practicable method <br /> - - - - _ -- _ - - _ ___._ _ _ __- __ _ - - -,cOR.it I am,a small quantity generator,l have made <br /> _ - -• _- - _-_ ce:' c e m_ ^a'to o. All used oil from fhe generator listed above <br /> 3=-------= OR-c c°' haysrequ%edgy comply with Federal regulationsapp5cobletothe <br /> - -- _ _ " e`- '- '"_ �' 'rps beer dsclosed. Tne customer agrees to pay reasonable costs and attomey <br /> - _ - be ^S=ono cc_r ec ore underpenaltyoI' e u that the for oin is true and correct. <br /> DISPOSAURECYCLING FACILI'*': -GoJfection station` Industrial Agriculture Government MarneOther IndurMal Lu ating <br /> on <br /> Op <br /> a::LkNunjENII <br /> Nak4andg Or,Easl <br /> 'eltdey.NV 894X <br /> r" ;Generatoees <br /> oPrint Norrie Signature Dd Sfgnotvre <br /> r ea h t ea o ' obi a I'st ort ate rev e side of thisarm. <br /> 990/t90pi DNI SOAS ANd A110KHM 6090VLOLT XVd 9Z:9T TTOZ/ZZ/80 <br />
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