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ARCHIVED REPORTS XR0001567
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0508175
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ARCHIVED REPORTS XR0001567
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Entry Properties
Last modified
5/16/2019 2:33:08 PM
Creation date
5/16/2019 2:25:29 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001567
RECORD_ID
PR0508175
PE
2950
FACILITY_ID
FA0007977
FACILITY_NAME
WOOLSEY OIL CARDLOCK
STREET_NUMBER
1501
Direction
W
STREET_NAME
CHARTER
STREET_TYPE
WAY
City
STOCKTON
Zip
95206
APN
16337016
CURRENT_STATUS
02
SITE_LOCATION
1501 W CHARTER WAY
P_LOCATION
01
QC Status
Approved
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EHD - Public
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JRWARD - NON-HAZARDOUS WASTE MANIFEST <br /> 14 C O K 1' C R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. <br /> ERATOR, REQUIIEd,I?Ef3S�f�MPA TECTNEEQUIPMENT <br /> ggLOVES [:]GOGGLES ❑RESPIRATOR HARD HAT <br /> MAILING ElTY-VEK E]OTHER <br /> CITY: T' ,tZl�r{ t. �< �" " �`�- : ��t-~ '`- `! SPECIAL HANDLING PROCEDURES <br /> ,r <br /> PHONE <br /> CONTACT PERSON <br /> SIGNATIARIL OF I Y At TI7'CEDATIf7 <br /> * �.�J/�--� f i�fr'r fir—" mk.v✓e �� � <br /> WASTE TYPE - ,, _ ; _ RECEIVING,FA T}(' <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> •• ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY f° r .w (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> ir s <br /> NAME t�, y,a - r - . -ry'-. ._ ram NOTES' `�"> w:' " , "i TRUCK NUMBER <br /> ADDR <br /> � , t <br /> r CITY,STATE, ZIPS <br /> PHONE -' �.1. �'' -- `kr+ �. , , ,—,END DLJMP,,,,*a �,;BOTTOM DUMP TRANSFER <br /> f <br /> SIGNATIJ O AUTHORIZEQ AGEN7}OR DF IVER DATE Y X, ROLL'-OFF(ST!�, _FLAT—BED VAN DRUMS <br /> FORWARD INC. LANDFILL cusEc<YARsr <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 NIETH0, 1-' I(TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shall use r s -'$PbSE c='r <br /> *F BIO i AERATE 5Tl7CKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the Y, <br /> waste for any reason If f=orwards refusal to accept the waste is based on 1�/OIL <br /> weather or other site conditions Forward shall notify the Disposer when site Ii <br /> conditions are expected to change such that Forward will be able to accept l{ <br /> the waste _ ❑ SLUDGE II <br /> REMARKS- rr � ry �.• <br /> NON-FRIABLE <br /> FACILITY TICKET WMBER, i%-r''`'7``, NttJ�� ' -'� " �� ❑ ASBESTOS <br /> ❑ WOOD <br /> SIGNATURE pF AUTHORIZ�Ct AGENTs k` sr sT DATE <br /> - Y ❑ ASH <br /> OTHER <br /> SCHEDULING MUST BE MADE PRIOR 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 MANIFEST # S 0 0 L 4 <br /> bum 1111164"Y <br />
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