My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0004956
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
M
>
MOSSDALE
>
444
>
3500 - Local Oversight Program
>
PR0545585
>
ARCHIVED REPORTS_XR0004956
Metadata
Thumbnails
Annotations
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
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
129
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
FORWARD. NON-HAZARDOUS WASTE MANIFEST <br /> b <br /> INR P O�R A T E D h WASTE TREATMENT AND DISPOSAL FACILITY <br /> C O <br /> ACCEPTANCE N0. <br /> '43E_NERATOFF �: - ' ` '` REQUIRED PERSONAL.PROjECTNE EQUIPMENT,� .. .._ <br /> Md Soddes Pcbvkm GLOVES [-]GOGGLES [:]RESPIRATOR ®HARD HAT <br /> MA1t.ING iA}DRESS - ❑TY-VEK [-]OTHER <br /> 5.21 West Fine!fit <br /> ATE, P --'� SPECIAL HANDLING PROCEDURES <br /> STx <br /> • <br /> (209)943-2011 .i.... . i. - • =e <br />' CONTACT PERSON <br /> IGNAi1JRE OF AUS IOR ZED A EG NT/ TITLE DATE <br />' WASTE TYPE _ w� _ _ RECEIVING FACILITY <br />' ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> • DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br />' ❑ CONSTRUCTION SOIL ❑ ASH <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br />' 44dMondale Reed LATHWP (209) 982- 1009 FAX <br />' NAME _�;��j �� (� S , TRACTOR LIC # GI [,5# p -7,0 TRUCK NUMBER <br /> i t 1 <br /> ADDRESS-_ - __ _ _ TRAILER LIC # <br />' G1TY STATE,ZIP -1 S v _ " TRAILER LIC # <br /> PHONE_ �p� -- --�2'z�p _ END DU _ BOTTOM DUMP _ TRANSFERw <br /> Qr - ❑ ❑ <br /> • SIG RE OFA THORIZ AGENT-OR DRIVER DATE ROLL-OFFS) <br /> FLAT-BED VAN DRUMS <br /> - ❑ ❑ ❑ ❑ <br /> Of 117 2 <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste if weather or other <br /> conditions impair the sate and effective disposal of the waste or if the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the r�_� DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on r�OkL <br /> weather or other site conditions Forward shall notify the Disposer when site S <br /> conditions are expected to change such that Forward will be able to accept <br />' the waste _ - N w ❑ SLUDGE <br /> • REMARKS <br /> NON-FRIABLE <br /> ❑ ASBESTOS <br />' ng TY TICKET NUMBER _ _ <br /> �.� -- -- - [] WOOD <br /> 1GNAATURE_OF AUTHORIZED AGENT DATE, <br /> -- - f' - - ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br />' SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL(209)98 4298 ' <br /> FO (C951 1 NH)6-96 Hl r SALES COPY MANIFEST # C 720228 <br /> 20228 <br />
The URL can be used to link to this page
Your browser does not support the video tag.