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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
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EHD - Public
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Rif�1Z <br /> y l <br /> 1 <br /> L� FORwARD SITE TICKET GRID <br /> INCORPORATED 01 151111 D-98 <br /> 199 South Austm Road/WEIGHING LOCATION P 0 Box 6336 WEIGHMASTER <br /> F <br /> eta, CA 95336 Stockton, CA 95206 V. PONCE <br /> fe"I (209) 982-4298/WEIGHING LOCATION Main Office (209) 466-4482 DATE IN TIME IN <br /> urce Recovery (209) 982-4936 Fax (209) 465-0631 10/12/99 10:05 <br /> 883400 DATE OUT TIME OUT <br />' ADVANCED GEO ENVIRONMENTAL 10/12/99 10:05 <br /> BILL LITTLE VEHICLE ROLL OFF <br /> 4005 N. WILSON WAY <br />' STOCKTON CA 95205-2486 REFERENgL__t ORIGIN <br /> 883400 MELRARIDES PETROLEUM <br />' Scale 1 Gross Weight 63480 LB Inbound - Charge tsclet <br /> Stored Tare Weight 30400 LES <br /> Net Weight 3311 LES <br /> QTY UNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br /> 16. 541 TONS Class 11 Soil by Ton <br /> r <br /> IGNMASTER CERTIFICATE THIS IS 70 CERTIFY That the following oescribed commodity was weighed measured or counted by a weighmoster whose signature is <br /> this certificate who is a recognized outhonty of occurccy as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business <br /> Professions Code administered by the Division of Measurement Standards of the California Department of Food and Agriculture <br /> NET AMOUNT <br /> MANIFEST # 720234 <br /> TRUCK # 9B07682 <br /> P.O. # NONE TENDERED <br /> TRAILER ## 1 UE454i t <br /> Schedule 24 hours in advance directly � th the 1 ndfil. l . CHANGE <br /> Call (209 )982-4298 to schedule . <br /> Drive Safely ' ' / CHECK NO <br /> . G� <br /> recycled paper <br /> DRIVERS SIGNATURE �, <br />
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