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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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EL DORADO
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6009
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3500 - Local Oversight Program
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PR0544720
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
8/1/2019 9:47:34 AM
Creation date
8/1/2019 9:27:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0544720
PE
3528
FACILITY_ID
FA0024188
FACILITY_NAME
ARCO AM/PM
STREET_NUMBER
6009
Direction
N
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95207
APN
08126064
CURRENT_STATUS
02
SITE_LOCATION
6009 N EL DORADO ST
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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Recycled Paper <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 5379 <br /> Generator: �1/ ' 7-v r 'f%,� rJ. ;f� ✓ <br /> Address: ----- <br /> Phone: ( ��� ) - . 'ill Contact., <br /> . �. �. -� <br /> Transporter: � -- - --- <br /> Add ress: csC; <br /> Phone: 3 e-) - f Contact: Z ✓� G <br /> I hereby certify that the above named material, was picked up at the generator site listed above. <br /> Driver Signature: <br /> Shipment Date:— <br /> Truck <br /> ate:Truck No.: Load No.:' . <br /> Vehicle License No./State: <br /> Consultant/Contractor: l1 5����;�% S' �P ��: - <br /> Address: Y� % �_ , <br /> Phone: ( )o `fir' 2 - 4�K Contact: . <br /> I hereby certify that the above named material is consistent with thb-information presented in the Waste,Cf airacteriza a 'n Fprm:_ <br /> and Contaminated Soil Description Form,and has been-properly described,classified and packaged,ands in proper}c ndittion <br /> for transport according to applicable regulations. <br /> Name: Date: ---- <br /> Destination: Forward, Inc. <br /> 9999 South Austin Road, Manteca, California95336 <br /> (209) 982-4298 <br /> Received by: <br /> Date: — <br /> Acceptance No.: � <br /> This load contains soil with: <br /> less than 100 ppm greater than 100 ppm <br /> r <br /> A COPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE-LOAD, AND MUST BE SUBMITTED AT THE* ATE FOR <br /> ENTRY.ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE: (209)1982-42. 98 .LANDFILL DELIVERIES <br /> MUST BE SCHEDULED ON A DAILY BASIS. ANY UNSCHEDULED LOADS MAY REFUSED AT THE GATE. <br /> Yards Per this Load: t- <br /> WHITE-FACILITY COPY: YELLOW TRANSPORTER COPY PINK-GENERATOR COPY <br />
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