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ARCHIVED REPORTS XR0006810
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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EAST
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2360
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3500 - Local Oversight Program
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PR0544639
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ARCHIVED REPORTS XR0006810
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Entry Properties
Last modified
7/9/2019 5:07:40 PM
Creation date
7/9/2019 3:23:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006810
RECORD_ID
PR0544639
PE
3528
FACILITY_ID
FA0005076
FACILITY_NAME
DICKS EXXON
STREET_NUMBER
2360
STREET_NAME
EAST
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23346001
CURRENT_STATUS
02
SITE_LOCATION
2360 EAST ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\wng
Tags
EHD - Public
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Recycled Paper RECEIVED AUG 2 6 M2 <br /> --------------- <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> _ 02348 <br /> Generator <br /> Address L4 <br /> Phone <br /> Contact tY] r7�GL <br /> 1 � <br /> Transporter <br /> Address <br /> Phone Contact e'5e-%!!7/S, Z' <br /> I hereby certify that the above named material was picked up at the generator site listed above <br /> t <br /> Driver Signature <br /> Shipment Date <br /> Truck No Q Load No <br /> Vehicle License No/State _ ' <br /> d0ultant/ContractorAddress / `f 6, 1:2. nC S C' <br /> Phone Contact <br /> I hereby certify that the above named material Is consistent with the Information presented in the Waste Characterization Form <br /> and Contaminated Soil Description Form,and has been properly described,classified and packaged,and Is In propercondltlon <br /> for transport according to applicable regulations <br /> Name Date <br /> Destination Forward, Inc <br /> 9999 South Austin Road, Manteca, Callfornla 9533 <br /> (209) 982-4298 <br /> Received by <br /> n <br /> Date <br /> Acceptance No <br /> This load contains soil with <br /> x - less than 100 ppm greater than 100 ppm <br /> PY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> E RY ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE (209)982-4298 LANDFILL DELIVERIES <br /> MUST BE SCHEDULED ON A DAILY BASIS ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE <br /> t c-. <br /> Yards Per this Load <br /> TRANSPORTER COPY <br />
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