My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COWZIRJV0 (2)
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
T
>
THORNTON
>
14749
>
2500 – Emergency Response Program
>
COWZIRJV0 (2)
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
1/5/2022 3:47:15 PM
Creation date
1/5/2022 3:43:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COWZIRJV0
PE
2546
STREET_NUMBER
14749
Direction
N
STREET_NAME
THORNTON
STREET_TYPE
RD
City
LODI
Zip
95242
APN
05515026
ENTERED_DATE
12/8/2020 12:00:00 AM
SITE_LOCATION
14749 N THORNTON RD
RECEIVED_DATE
12/8/2020 12:00:00 AM
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
42
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
Please print or type. Form Aporoved. OMB No. 2050-0039 GENERATOR ) I UNIFORM HAZARDOUS <br />WASTE MANIFEST <br />1. Generator ID Number <br />CAL000425370 <br />2. Page 1 of <br />1 <br />3. Emergency Response Phone <br />800-535-5053 <br />4. Manifest Tracking Number <br />030026210WAS <br />Generator's Name and Mailing Address Generator's Site Address (if different than mailing address) <br />ECMB CORP DBA 1ST STOP CAR CARE 3008 N 2ND AVE <br />3008 N 2ND AVE SAN DIEGO CA, 91910 <br />CI-IULA VISTA CA, 91910 <br />Generator's Phone: 619-843-5589 I <br />Transporter 1 Company Name U.S. EPA ID Number <br />AGRITEC INT DBA CLEANTECH ENVIRONMENTAL I CAL000330453 <br />Transporter 2 Company Name U.S. EPA ID Number <br />I <br />Designated Facility Name and Site Address U.S. EPA ID Number <br />AGRITEC INT DBA CLEANTECH ENVIRONMENTAL CAL000330453 5820 MARTIN RD <br />IRWINDALE CA, 91706 <br />Facility's Phone: 626-812-7200 I <br />ga 9b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 10. Containers 11. Total 12. Unit 13 Waste Codes Firvi and Packing Group (if any)) No. Type Quantity Wt.Nol. <br />7 <br />1. <br />2. NON-RCRA HAZARDOUS WASTE SOLID (ABSORBENT/PAPER FILTER MEDIA) <br />1 DM 200 P I- 352 <br />3. NON-RCRA HAZARDOUS WASTE SOLID (OILY SOLID WASTE/USED METAL OIL <br />FILTERS) 2 DM 600 P _I <br />352 <br />4. <br />,,--I <br />14. Special Handling Instructions and Additional Information <br />Line 2: USE GLOVES AND GOGGLES CALLER MUST IDENTIFY CLEANTECH ENVIRONMENTAL AS REGISTRANT INFOTRAC 800-535-5053; Line 3: USE GLOVES <br />AND GOGGLES CALLER MUST IDENTIFY CLEANTECH ENVIRONMENTAL AS REGISTRANT: INFOTRAC 800-535-5053; <br />15. GENERATOR'S1OFFEROR'S CERTIFICATION: I hereby dedare that the contents of this consignment are fully and accurately described above by the proper shipping name, and are classified, packaged, <br />marked and labeled/placarded, and are in all respects in proper condition for transport according to applicable international and national governmental regulations. If export shipment and I am the Primary <br />Exporter, I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent <br />I certify that the waste minimization statement Identified in 40 CFR 262.27(a) (if I am a large quantity generator) or (b) (if I am a small quantity generator) is true. <br />Generators/Offeror's Printed/Typed Name Signature Month Day Year <br />I <br />I 12 1 22 1 2020 <br />..,-1 16. International Shipments Import to U.S Export from U.S. Port of entry/exit: <br />Transporter signature (for exports only): Date leaving U.S.: TRANSPORTER 17. Transporter Acknowledgment of Receipt of Materials <br />Transporter 1 Printed/Typed Name Signature Month Day Year <br />I <br />I 12 1 22 1 2020 <br />Transporter 2 Printed/Typed Name Signature Month Day Year <br />I I I I I DESIGNATED FACILITY 18. Discrepancy <br />Discrepancy Indication Space jJ Quantity DYPe El Residue Partial Rejection Full Rejection <br />Manifest Reference Number: <br />Alternate Facility (or Generator) U.S. EPA ID Number <br />Facility's Phone: I <br />Signature of Alternate Facility (or Generator) Month Day Year <br />I I I <br />19. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />1. 2. <br />H141 <br />3. <br />H010 <br />4. <br />20. Designated Facility Owner or Operator: Certifica on of receipt of hazardous materials covered by the manifest except as noted in Item 18a <br /> <br />Printed/Typed Name Signature Month Day Year <br /> <br />Cristina Perez I Cristina Perez I 12 I 28 1 2020 <br />EPA Form 8700-22 (Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM
The URL can be used to link to this page
Your browser does not support the video tag.