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ARCHIVED REPORTS_XR0008249
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0545005
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ARCHIVED REPORTS_XR0008249
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Entry Properties
Last modified
12/3/2019 2:49:19 PM
Creation date
12/3/2019 2:41:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008249
RECORD_ID
PR0545005
PE
3528
FACILITY_ID
FA0025603
FACILITY_NAME
SAN JOAQUIN BEVERAGE
STREET_NUMBER
1149
Direction
W
STREET_NAME
WEBER
STREET_TYPE
ST
City
STOCKTON
Zip
95203
CURRENT_STATUS
02
SITE_LOCATION
1149 W WEBER ST
QC Status
Approved
Scanner
SJGOV\wng
Tags
EHD - Public
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JRWARI], INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> l,arka ���-r � 01377 <br /> Generator Bank of Stockton G�nerct �r t� t -)Cat-ion 1 ; ort W �� ih <br /> Address � n , Ln r,,e. <br /> Phone { ?0�} C341 - 1375 Contact Jc--hn UrrUt-1a <br />' <br /> Transporter M P Fnvironmc-r,:aI Ser,,-crs , rte <br />' Address 7 c- r=_ 'I <br /> Phone (' ^16) 568 - (" 16 Contact Fd Morrisnn <br /> I hereby certify that he above named material was picked up at the generator site listed above <br /> M <br />' Driver Signature r <br /> Shipment Date y <br /> Truck No <br /> Load No <br /> Vehicle License No/State -� <br /> IsLisultant/Contractor - - <br /> Address P. 7 Ccx 200 , Frrlsnm, CI _ 256;0 <br />' Phone { g 1 6} � _ -,.,� _ <br /> - 1 �Contact <br />' I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Form <br /> and Contami ted Soil Description-Form,and a's been properly described classified and packaged,and is in proper condition <br /> for transpo ac ordi o plicabl r Description-Form, <br /> n - <br />' Name <br /> Date <br /> r <br /> Destination Forward, Inc <br /> 9999 South Austin oad, Manteca, California 95336 <br /> (209) 982-4298 - <br /> Received by ` <br /> Date <br /> IAcceptance No 92 174 <br /> This load contains soil with <br /> IDiesel C,nntam voteless than 100 ppm <br /> greater than 100 ppm <br /> JPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOR <br /> TRY 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 /> Yards Per this Load l L. <br /> TRANSPORTER COPY <br />
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