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ARCHIVED REPORTS XR0009677
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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EL DORADO
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3430
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3500 - Local Oversight Program
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PR0544710
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ARCHIVED REPORTS XR0009677
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Entry Properties
Last modified
7/30/2019 1:37:16 PM
Creation date
7/30/2019 11:58:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009677
RECORD_ID
PR0544710
PE
3528
FACILITY_ID
FA0006247
FACILITY_NAME
Western Lift
STREET_NUMBER
3430
Direction
S
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
17525063
CURRENT_STATUS
02
SITE_LOCATION
3430 S EL DORADO ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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este <br /> No. 79809 .E <br /> Jystems TM H <br /> 4-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST- <br /> GENERATOR <br /> Generator Name Bank of Stocktor, wi_=ster-n ;_if 4 <br /> Generating Location IN ' <br /> Address F. 0. Box 1110 2420 S . El Corcdo <br /> Address i <br /> Stockton , Ca . 95209 S;.c,_ktor , C:n _ <br /> .Phone No. 0 9 "� 1 3 7 <br /> Phone No. <br /> BFI Waste Code m Containers Type <br /> Description of Waste Quantit Units No. T e D- Drum <br /> 11P /� I <br /> OL Oiesal C.ontarn-Inatad So� � q � m T C-Carton <br /> B - Bag <br /> T -Truck <br /> ❑ P - Pounds ; <br /> Y-Yards <br /> ❑ m ❑ O-Other <br /> hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR_Part 261 or any applicable state law, has been properly described, <br /> classified and packaged, and is in proper condition transpo ation according to applicable regulations. <br /> Ronald K. Rinehart (_ <br /> Generator Authorized Agent Name Signature <br /> Shipment pate <br /> Truck No. Phone No. 916 5 5 S-9' ", 5 <br /> Transporter Name M P Environment-a 1 Services ) n <br /> • driver Name (Print) <br /> Address 3400 Manor Streit Vehicle License No./Statel::2� 6ao <br /> Bakersfield , C a _ 93308 <br /> Vehicle Certification 3 _ <br /> 7. _- <br /> i hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the generator site listed above. ou ' cident to the destination listed below. f <br /> D r Signature Shipment Date Driver Signature Delivery Date <br /> z'• .Sign <br /> �. ,r—�•-- ; <br /> DESTINATION <br /> I.SiteName Vasco, Road Sanitary Landfill � 1 0 Y 4[_7T <br /> 9 1 <br /> Phone No. �— <br /> Address 4001 Vasco Road , ' Livertnore, Ca _ 94550 <br />.1 hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> IIIIIIIIIIIII11ahorized Agent SI nature <br /> Receipt ate <br /> PASS CODE <br /> SF128a-720 ; <br /> TRANSPORTER RETAIN i <br />
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