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COX65NPYB (2)
Environmental Health - Public
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2500 – Emergency Response Program
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COX65NPYB (2)
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Last modified
3/23/2022 4:21:06 PM
Creation date
3/23/2022 4:16:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COX65NPYB
PE
2546
FACILITY_NAME
STOCKTON DOWNTOWN MARINA
STREET_NUMBER
705
Direction
W
STREET_NAME
WEBER
STREET_TYPE
AVE
City
STOCKTON
Zip
95202
APN
13701006
ENTERED_DATE
10/11/2021 12:00:00 AM
SITE_LOCATION
705 WEST WEBER AVE
RECEIVED_DATE
10/11/2021 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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Please Orint or tyoe <br /> Form Approved OMB No. 20500039 ERATOR . I UNIFORM HAZARDOUS WASTE MANIFEST <br />(Continuation Sheet) <br />21 Generator ID Number <br />CAC 6 o-311-1L1 ii O7 <br />22 Page <br />2 1j__ <br />23. Manifest Tracking Number <br />0 tlaio19,12,1 Li: <br />Generators Name Pk L cx-rkemi'.30^ <br />LI . 19 R i vetAle,i4V; CC STee_t_TotA CO, 9 5 2. t ci <br />US EPA ID Number <br />Transporter 3 Company Name"; i \ A Rcycjit..is -1") 1 e-meArrY c, I (2.. A R 600 Iity Li 7 <br />U.S. EPA ID Number <br />Transporter Company Name <br />I <br />27a 27b. U.S. DOT Cescriplion (including Proper Shipping Name, Hazard Class ID Number. 28. Containers 29. Total 30. Unit 31. Waste Codes <br />HM and Packing Group (if any)) No. Type Quantity WI Not. -. GEN \dr N <br />e) <br />/ <br />32 Special Handling Instructions and Additional Information VSPORTER 33 Transporter ? Acknowledgment of Receipt of Matenals <br />Printed/Typed Nanui. i Signature Month Cay Year <br />flk.A5C, Ariv-z-t I -_--_,...--- 1 1( 1 2-1 2 1 <br />Transporter Acknowledgment of Receipt of Matenals <br />1— g Pnrted/Typed Name Signature Month Day Year <br />I III DESIGNATED FACILITY Discrepancy <br />Hazardous Waste Report Management Method Codes (1.e., codes for hazardous waste treatment disposal ard recycling systems) <br />I I I I <br />I I I <br />EPA Form 8700-22A (Rev. 12-17) Previous editiols are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM
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