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COPFPNNPH (2)
Environmental Health - Public
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ANDERSON
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2500 – Emergency Response Program
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COPFPNNPH (2)
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Entry Properties
Last modified
11/30/2022 12:30:51 PM
Creation date
11/30/2022 12:21:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COPFPNNPH
PE
2546
STREET_NUMBER
725
Direction
W
STREET_NAME
ANDERSON
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
NEAR 16326025
ENTERED_DATE
6/21/2022 12:00:00 AM
SITE_LOCATION
725 W ANDERSON ST, STOCKTON CA 95206
RECEIVED_DATE
6/21/2022 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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19aLC-0 6 10498 (Rev. 9/09) <br />Facx...e.ritisse •:;trez.. ;".4*.^. 4:- ; .1 <br />. ., .. I I , , • . r ' ... t , • 1 <br /> <br />A 1. • , <br />' U.S. EPA ID Number <br />CA0000'180797 <br />Soneratrn'a Morn. • a89•93M#00 <br />8, Transporter 1 Cornparry flame <br />Peatke'ErreteMilall Sati$X3 <br />2. 'W41 <br />SO'C'P <br />a <br />EITyp e 0 Ramie 0 Full Relactecn 0 Part! el Refealen <br />17a, Discrepancy Indicalinn Space Quantity <br />U.S. EPA ID Mather <br />Mandate Reference Number 17b. Alternate Facility (or Generator) <br />1 g Fartitys Phone: <br />0 17e. Signature al Altentato r atiny (oi Ilenetator) WO Day 4 <br />gal*/ &ESN DIV Win <br />a <br />7 St ROCieri 95405 <br />(3eneratoes Site Address (8 &scent than marng address) <br />V,Zrr 4.?".""."•zv t'AITE,VM. <br />Ji 4' • :4.•Ra4•53',. <br />A, <br />si <br />Ii4f 4. <br />.14Z.43.(P('‘ Jr" • <br />1:751:4 <br />4 <br />• N0N4(AZARD414 <br />ANTE ST <br />cailtaggis.64 3. EnteroMae <br />265 5SYtitda12 <br />U.S. EPA it) Number <br />lal,infi2pe57"/ us. EPA ID ft:mbar <br />• <br />520.753.1829 11 A <br />04; <br />14"r <br />'1•411C:4- ' kw:414 <br />No. • <br />10. Contain <br />AtP8 <br />a <br />14.1384E4ATill'81/101,1'S CERTIFICATION: I hereby declare that the contents of this consIgnmeriPre fitly anda'ccutatety described above try the proper shippIng name, and am classified, pawed, marked and labeled/Oa:Weil, and am In all respects in prop or panoltion.for transport according tonarble international and national govenurtental reR",e. <br />GanendoteiOttaror's Prtniegyped Name Sn4wa 91‘) ti" a Month Day Year <br />P11.195.$ I ...ceir <br />C9 4- <br />An-c, 5-1474 IDA e fi <br />Transeortedloriature (tor exports only): <br />. Month Day Year <br />I (P)I 1 12 <br />Month PM!' <br />17. Discrepancy <br />z <br />15: triternatIon al Stiprnents ' L.._1 Import to U.S. 0 em eft fra”rn <br />2. Page ol <br />4 ' <br />14. swittur tristaxd* and Arigtonal Information <br />, 'ROD 2S2•3$.9 • <br />fttfra 44029 • .0 <br />8:10esrantlarne end Site <br />geravisCuteAKElatil <br />Menet <br />9. Waste StdpAng Name and Description 11. Total <br />stuPD <br />itrt ol entryt <br />Date leaving U.S.
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