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CO0054728 (3)
Environmental Health - Public
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CO0054728 (3)
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Entry Properties
Last modified
11/19/2024 10:36:12 AM
Creation date
1/20/2023 3:01:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0054728
PE
2546
STREET_NUMBER
0
Direction
S
STREET_NAME
I-5
City
LODI
Zip
95242
APN
NEAR 02510006
ENTERED_DATE
3/1/2022 12:00:00 AM
SITE_LOCATION
SOUTH BOUND HWY 5 NORTH OF HWY 12
RECEIVED_DATE
3/1/2022 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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Please print or type. Form Aøgroved. OMB No. 2 - A GENERATOR UNIFORM HAZARDOUS WASTE MANIFEST <br />(Continuation Sheet) <br />21. Generator ID Number <br />CAC0031651305 <br />22. Page <br />2 <br />23. Manifest Tracking Number <br />016996394FLE <br />Generator's Name JT Cargo Inc <br />38.126107. -121.400993 <br />Lodi, CA 95242 <br />U.S. EPA ID Number Transporttr hPronnSomoanv Name <br />enml management Technologies, Inc CAR000183574 <br />U.S. EPA ID Number Transporter Company Name <br />I <br />27a. 27b. U.S. DOT Description (including Proper Shipping Name, Hazard Class, ID Number, 28. Containers 29. Total 30. Unit 31. Waste Codes HM and Packing Group (if any)) No. Type Quantity Wt.Nol. <br />i <br />Special Handling Instructions and Additional Information <br />ce <br />W i—ce <br />0 ii. 2 <br />g <br />I- <br />Transporter 3 Acknowledgment of Receipt of Materials <br />Printed/Typed Name Signature Month Day Year <br />7 ct-CAA y....., ; -,.... 1 I I z6 -z-t- <br />Transporter Acknowledgment of Receipt of Materials <br />Printed/Typed Name Signature Month Day Year <br />I I I I DESIGNATED FACILITY Discrepancy <br />Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />I I I I <br />I I I I <br />EPA Form 8700-22A (Rev. 12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM
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