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ARCHIVED REPORTS XR0005571
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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COLONY
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1442
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2900 - Site Mitigation Program
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PR0541478
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ARCHIVED REPORTS XR0005571
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Entry Properties
Last modified
8/19/2020 3:34:19 AM
Creation date
10/10/2018 11:21:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS XR0005571
FileName_PostFix
XR0005571
RECORD_ID
PR0541478
PE
2950
FACILITY_ID
FA0023778
FACILITY_NAME
CHEVRON STATION #210997
STREET_NUMBER
1442
Direction
W
STREET_NAME
COLONY
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
26102028
CURRENT_STATUS
01
SITE_LOCATION
1442 W COLONY RD
P_LOCATION
05
P_DISTRICT
004
QC Status
Approved
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TMorelli
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EHD - Public
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a R <br /> j FQJ 11`� SITE TICKET GRID <br /> P RA ? ED <br /> I N R O D 144050 <br /> 19 th Austin Road/WEIGHING LOCATION P O Box 6336 WEIGHMASTER }° <br /> laW,CA 95336 , :1 Stockton, CA 95206 K- SPARKS <br /> ind i (209)982-4298/WEIGHING LOCATION Main Office (209) 466-4482 DATE IN TIME IN <br /> esource Recovery (209) 982-4936 Fax (249)465.0631 08/11/99 08:42 <br /> 8665000 DATE OUT TIME;Our <br /> SEMG9 08/11 /99 08:42 <br /> ;MARK WRY 01 VEHICLE ROLL OFF <br /> 1217 b TH 7th STREET JAYLOR T5 <br /> MODEST© SA 956y5 1 REFERENCE I ORIGIN <br /> • 866500 NELSON READY MIX <br /> Manual Gross Weights 86000 - LB Inbound _ Charge ticket <br /> Manual TAre Weight 33300 LS <br /> Net Weight 52700 LB <br /> QTY UNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br /> 26.3 TONS Class II Sall by Ton <br /> r <br /> I <br /> f <br /> 5 <br /> 1 <br /> fEIGHMASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or counted by a weighmaster whose signature Is <br /> n this certificate who Is'a recognized authority of accuracy as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business <br /> nd Professions Code administered by the Division of Measurement Standards of the California Department of Food and Agriculture <br /> NET AMOUNT <br /> MANIFEST" # 4999 { , �"{++ .� u <br /> TRUCK # 9A93261 <br /> P.O. # NONE PROVIDED Ir I TENDERED <br /> + <br /> Schedule 24 hours In advance directly. with , the landfill . CHANGE <br /> Call (209 )9B2-4298 to schedule. ti `` ' <br /> Drive Safe 1 y l + CHECK NO <br /> A recycled paper <br /> DRIVER'S SIGNATURE �� <br /> 4 I <br /> f <br />
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