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ARCHIVED REPORTS_XR0004956
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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M
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MOSSDALE
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444
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3500 - Local Oversight Program
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PR0545585
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ARCHIVED REPORTS_XR0004956
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Entry Properties
Last modified
9/16/2020 2:05:33 AM
Creation date
3/19/2020 3:30:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004956
RECORD_ID
PR0545585
PE
3528
FACILITY_ID
FA0000212
FACILITY_NAME
Mossdale Chevron
STREET_NUMBER
444
Direction
W
STREET_NAME
MOSSDALE
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
02
SITE_LOCATION
444 W MOSSDALE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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"j,f <br /> FORWARD <br />' S1TE TICKET GRID <br /> �b INCORPORATED 01 111207 D-98 <br /> WEIGHMASTER <br /> 199 South Austin Road/WEIGHING LOCATION —P O Box 6336 V. PONCE <br /> Iteca, CA 95336 Stockton, CA 95206 TIME IN <br /> fill (209) 982-4298/WEIGHING LOUTION Main Office (209) 466-4482 DATE IN <br /> urce Recovery (209) 982-4936 Fax (209) 465-0631 10/12/99 15:3 3 <br /> 8834oO DATE OUT TIME OUT <br />' ADVANCED GEO ENVIRONMENTAL 10/12/99 15:33 <br /> BILL LITTLE VEHICLE ROLL OFF <br /> 4005 N. WILSON WAY LUTREL 63 <br /> STOCF�TON CA 952r_r5-2486 REFERENCE ORIGIN <br />' 883400 MELBARIDES PETROLEUM <br /> Scale 1 Gress Weight 69380 LB Inbound - Charge ticlet <br />' Stored Tare Weight 30400 LB <br /> Net Weight 38980 LP <br /> QTY UNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br /> 19.49 TONS Class 11 Soil by Ton <br /> JEIGHMASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or counted by a weighmaster whose signoture is <br /> n th,s certificate who is a recognized o.athonty of accuracy as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the Co0orna Business <br /> Professions Code odmmtstered by the Division of Measurement Standards of the California Department of Food and Agriculture <br /> NET AMOUNT <br /> MANIFEST # 720222 <br /> TRUCK' # 9b07682 <br /> F .O. # NONE - TENDERED <br /> u <br /> TRAILER # 1e4540 <br /> Schedule 24 hour s kn advance dit ectly with h la fill . CHANGE <br /> Call (209 )982-42913 to schedule. <br />' Drive Safely " �� J CHECK NO <br /> recycled paper <br /> DRIVER'S SIGNATURE <br /> 1 <br />
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