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ARCHIVED REPORTS_XR0012743
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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K
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KETTLEMAN
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601
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3500 - Local Oversight Program
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PR0545338
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ARCHIVED REPORTS_XR0012743
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Entry Properties
Last modified
4/9/2020 9:06:40 AM
Creation date
2/12/2020 8:31:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012743
RECORD_ID
PR0545338
PE
3528
FACILITY_ID
FA0003803
FACILITY_NAME
KETTLEMAN CHEVRON
STREET_NUMBER
601
Direction
E
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04728006
CURRENT_STATUS
02
SITE_LOCATION
601 E KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Waste <br /> sterns "' NON-I-IAZARDOUS SPECIAL WASTE MANIFEST <br /> conlaillel's <br /> units Ile. c1litoll <br /> Phone No. 1311.Doe NO. <br /> BF-I%,I CD(i4` VJ a s I In B-Bag <br /> .T TrLIck <br /> p Pounds <br /> ,dl <br /> y Y, <br /> 0.Other <br /> Part 260.10 or arly aPlic� <br /> '15 d0jine <br /> d by 40 CFR -tIY described, <br /> v namod dO;)s [101 coil' free liclulfj wis been proplo <br /> able SICItO law- <br /> I hereby CelLilY It""1110 above�,,Usje as deline(I by 40 cr-npzat 261 or Any UPPlic <br /> stale 10W, is not a jiazardol,15 tioll toir trai ispo r I-,'ti011 iucorOing 10 applicable'e• 11iolls. <br /> ctassilied and packaged,and is in proper CORdi <br /> nt oate <br /> 77; <br /> i am <br /> Phone NO. <br /> Truck No. <br /> Driver Name(print) <br /> Trinsportm Name <br /> VP No./Stalle <br /> Vehicle License <br /> Address <br /> Vehicle Certification teTial was delivered with, <br /> I helej)y certify that the IbOvc named mmed Io- <br /> ,1tefiLlt�qas p+ckcd up deslill@tj011 listed below. <br /> I hereby cr,1110�1 that(lie above It out illv'icluol to IIIa <br /> it lho generator 5!1e VS10d above. <br /> D�1 <br /> V 10'� e i� , it <br /> 777=417716 UT. <br /> k P.-Ai <br /> j7 <br /> ;.z <br /> Ll <br /> I It lone No. <br /> Silo Nal me <br /> and <br /> bast Of Illy ki-)OW0t190 Ile jorcgo�nq is true ac"mite. <br /> �jcccpind and to the <br /> above 111lUd inate-fillt Jjjs boc.11 <br /> I 01"Ittify tKil 1110 , <br /> —1:111—Fleco; I Dato <br /> --7 ----I <br /> PASS GOi)V- <br /> Drmo 720 <br /> 114"i `-M! <br />
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