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COMPLIANCE INFO_2020
Environmental Health - Public
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2200 - Hazardous Waste Program
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PR0542379
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COMPLIANCE INFO_2020
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Last modified
12/2/2020 1:05:59 PM
Creation date
11/2/2020 10:50:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0542379
PE
2220
FACILITY_ID
FA0024348
FACILITY_NAME
BATH & BODY WORKS #65
STREET_NUMBER
5308
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
5308 PACIFIC AVE STE 6
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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EyspertSUSTAINABILITY <br /> Land Disposal Restriction Notification <br /> Generator Name: Bath&Body Works#65 <br /> EPA Number: CAL000427614 <br /> Generator Address: 5308 PACIFIC AVE STOCKTON,CA <br /> Manifest Tracking Number: 010685568FLE <br /> Instructions <br /> Column 1:List the Manifest Line number or Manifest Line item. <br /> Column 2:Identify all U.S.EPA hazardous Waste Codes that apply to this shipment. <br /> Column 3:Choose the appropriate treatability group:Non-Wastewater(NWW)or Wastewater(WW). <br /> Column 4:Enter the appropriate Subcategory(per 40 CFR 268.40),if applicable,and also enter"Contaminated Soil"or"Debris"if the waste will be <br /> treated using one of the alternative treatment technologies provided by 268.49(c)-soil,or 268.45-debris. <br /> Column 5:Enter the letter of the appropriate paragraph from below(see Appendix 1 for other options if needed) <br /> Column 6:For F001-F005,please enter the Reference Number(s)located below for the constituents in your waste stream subject to treatment. <br /> Column 7:For F039,D001-D043,Debris&Contaminated Soil:please list the Reference Numbers listed in Appendix 2 for any Underlying Hazardous <br /> Constituents, <br /> Check One <br /> Manifest Line Number U.S.EPA HazardousHow Must This Regulated Underlying Hazardous <br /> or Manifest Line Item Waste Codes Sub-Category Waste Be Constituents Constituents <br /> NWW WW Managed? For F001-F005 for D001-D043, <br /> 1 -110905 <br /> -- Debris or Soil <br /> _ _.. <br /> D001,U002 Yes High TOC Ignitable A <br /> Liquid <br /> 2-110904 D001 Yes Ignitable A <br /> Charecteristic <br /> Waste <br /> Column 5 Waste Management Codes <br /> A THIS RESTRICTED WASTE REQUIRES TREATMENT TO THE APPLICABLE STANDARD.This waste must be treated to <br /> the applicable performance based treatment standard set forth in 40CFR Part 268 Subpart C,268.32,Subpart D,268.40 or <br /> RCRA Section 3004(d)prior to land disposal. <br /> Column 6 F001-F005 Reference Numbers <br /> Column 7 D001-DO43 Reference Numbers <br /> I hereby certify that all information subscribed at this and all associated documents is complete and accurate to the best of my knowledge and <br /> information. <br /> Generator Signature: C <br /> Title: — 6 <br /> Printed Name: ]1y, Z Z <br /> f �— Date: <br />
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