Laserfiche WebLink
SAN JOAQUIN DRAFT - Pending Environmental Health Department <br />coLdWy Consultant Verification <br />California Accidental Release Prevention Program <br />De -Registration Form <br />According to the California Code of Regulations (CCR), Title 19, Chapter 4. 5, Article Section <br />2745.10 (d), if a stationary source is no longer subject to the applicability requirements of <br />Section 2735.4(a)(2) the owner or operator shall submit a de -registration pursuant to Section <br />2740.1(b) to the UPA within six months indicating that the stationary source is no longer <br />covered. Complete this form and submit it to San Joaquin County Environmental Health <br />Department to de -register the process(es). <br />1. De -registration Submittal Date: <br />Pending <br />2. Effective Date of De -registration: August 2019 <br />3. facility Information: <br />Facility Name: City of Tracy Wastewater Treatment Plant <br />Physical Address <br />3900 Holly Drive <br />city: Tracy <br />County: <br />San Joaquin <br />Dun and Bradstreet Number: <br />State: CA <br />19-698-6004 <br />Zip Code: <br />95304 <br />Dun and Bradstreet number of the corporate parent company: 07-464-0111 <br />4. Owner/Operator Information: <br />Name: City of Tracy - Utilities Department Phone Number: (209) 831-6330 <br />Mailing Address: 333 Civic Center Plaza <br />zip <br />City: Tracy State: CA <br />Code: 95376 <br />5. Overall Responsibility for RMP Elements and Implementation: <br />Name: Aloke Vaid Job Title: Wastewater Operations Superintendent <br />6. Emergency Contact Information: <br />Name: AlOke Vald Phone Number: (209) 831-6328 <br />z4- Hour Phone number: (208) 697-8775 Email: aloke.vaid@cityoftracy.org <br />Page 1 of 3 <br />