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FIELD DOCUMENTS 1994-2010
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BEVERLY
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2900 - Site Mitigation Program
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PR0540667
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FIELD DOCUMENTS 1994-2010
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Entry Properties
Last modified
2/8/2019 8:40:52 AM
Creation date
2/7/2019 4:35:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
1994-2010
RECORD_ID
PR0540667
PE
2960
FACILITY_ID
FA0023252
FACILITY_NAME
WELDON CHURCH PROPERTY
STREET_NUMBER
104
Direction
W
STREET_NAME
BEVERLY
STREET_TYPE
PL
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
104 W BEVERLY PL
QC Status
Approved
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WNg
Tags
EHD - Public
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t-TOR-WAR.7. � 777NON-HV `" OUS WASTE MANIFEST <br /> I NC O R P O R A TWASTE TR5ENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Weldon Church []GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 197-8 Y^se tti to Roa <br /> CITY,STATE, ZIP SPECIAL HANDLING PROCEDURES: <br /> • Berkeley, CA 94707 <br /> _ - PHONE <br /> 610-524-0297 <br /> CONTACT PERSON <br /> William Little <br /> SIGNATURE OF AUTHORIZED AGENT"1 TITLE DATE <br /> *; 9 <br /> /Geolc'g is t 10/9/96 <br /> _ WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 104 ?gest Beverly <br /> Tr �Y , c (209) 982- 1009 FAX <br /> NAME NOTES: ` TRUCK NUMBER <br /> Eo, b Evans Truc%ink Q <br /> ADDRESS <br /> 21010 Fouth 11a.nteca Roar B oz <br /> . CITY, STATE, ZIP <br /> _,Ianteca, CA °S"7 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> 209-239-?407 0 ❑ ❑ <br /> SIGNATUgE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN" DRUMS' <br /> El <br /> FORWARD INC. LANDFILL CUBIC YARDS <br />.� Forward shall have no obligation to accept the waste if weather or other <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL METHOD: (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill. Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on <br /> weather or other site conditions, Forward shall notify the Disposer when site- 1- <br /> SOIL <br /> conditions are expected,to change•such that Forward will be able to accbpt— <br /> the waste. ❑ SLUDGE <br /> ` REMARKS <br /> – ❑ NON-FRIABLE <br /> FACILITY TIC�gT NUM BE ASBESTOSR, <br /> ,' / ❑ WOOD <br /> SIGNAT E F A ORIZED AG T DA <br /> ❑ ASH <br /> ❑ OTHER <br /> A <br /> SCHEDULING MUST BE MADE P,tf6q TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL (209) 982-4298 58005 <br /> MANIFEST # <br /> GENERATOR COPY <br />
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