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EHD Program Facility Records by Street Name
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FREMONT
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2911
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3500 - Local Oversight Program
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PR0545173
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Last modified
1/13/2020 1:35:03 PM
Creation date
1/13/2020 1:26:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545173
PE
3528
FACILITY_ID
FA0003492
FACILITY_NAME
United Rentals Branch 042
STREET_NUMBER
2911
Direction
E
STREET_NAME
FREMONT
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
14308057
CURRENT_STATUS
02
SITE_LOCATION
2911 E FREMONT ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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It�V Recycled Paper <br /> 4FbRWARD, INC. NON-HAZARDOUS -WASTE DRIVER :IDENTIFIcATIO:N FORM . <br /> 47.02 •.' <br /> Generator- A &. A TOOL RE.NTA4 <br /> Address: 2911 . E . . FREM014T AVE . STOCI<TON CA <br /> Phone: ( 2 0 9) 948 _ 9500 Contact: PAT; ..D O R A N <br /> T T Th y <br /> Transporter: � <br /> .Address: 1336 PAU Llfjt A V,E M OD E-S TO C A 95351 <br /> i <br /> Phone: (. 209) 578_ 4100 Contact: SCOTT MELLOQR <br /> I hereby certify that the above named material was picked up At-the:generator site listed above. <br /> Driver Signature:-.- • - <br /> Shipment Date: l - ( ' ' j. _-. <br /> Truck No.: � :_—Load No.: 03 <br /> <, ��,� f l( <br /> Vehicle License No./State: , ICA_ <br /> Consultant/Contractor: 1ef H F P N V T R 0 N n1 E i%I T A L - _ <br /> Address: P (1 R n Y R72P MODE.STO .CA '9.5350 1 <br /> Phone: ( 209) 670 _ 812 8Contact: STFVE FURNAS <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Form <br /> iJ}I <br /> and Contaminated Soil Description Form,and has been properly described,classified and packaged,and is in proper condition <br /> for transport according to applicable regulations. <br /> Name: � Date: ._. <br /> . <br /> Destination: Forward, Inc. b <br /> t <br /> 9999 South Austin Road; -&c a, Ca forma 95336 <br /> (209) 9824298 <br /> Received by:' <br /> Date: / 93 - <br /> Acceptance'No.: 9 Z 261 <br /> This load contains soil with:, <br /> less-than 100 ppm greater than 100 ppm <br /> A COPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD,-AND MUST BE SUBMITTED AT THE GATE FOR j <br /> ENTRY.ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE. (209)982-4298 LAN DFI LL DELIVERIES <br /> MUST BE SCHEDULED ON A DAILY BASIS. ANY-UNSCHEDULED:LOADS MAY BE REFUSED AT THE GATE. <br /> Yards Per this Load: Z� <br /> WHITE-FACILITY COPY- YELLOW-"TRANSPORTER COPY. PINK-GENERATOR COPY <br />
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