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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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4 <br /> 4 <br /> J Y 1 <br /> (& FORWARDr SITE TICKET GRED <br /> INCORPORATED T1 151074 - <br /> 499 South Austin Road/weiGH1NG LOCATIONP O Box 6336 V, PONCEWEIGHMASTER <br /> teca, CA 95336 Stockton, CA 95206 <br /> d 111 (209) 982 4298/WEIGHING LOCATION Main Once (209)466-4482 _ DATE IN TIME IN <br /> urce Recovery (209) 982-4936 Fax (209) 465-0631 10 U <br /> 883400 DATE OUT TIME OUT <br />' ADVANCED GED ENVIRONMENTAL 10 08:09 <br /> BILL LITTLE VEHICLE ROLL OFF <br /> 4005 N. WILSON WAY PAURDE T5 <br /> STOCI TON CA 95205-2486 REFERENCE f ORIGIN <br /> BB3400 MELBAR I DES PETROLEUM <br /> Scale 1 Grass Weight 63800 LB Inbound - Charge tictet <br />' Manual Tare Weight 33721--} LB <br /> Net Weight 30080 LES <br /> QTY UNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br />'• 577ass 11 Soily Ton <br /> 11bHMASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or counted by a weighmaster whose signoture is <br /> i this certificate who is a recognized authority of accuracy cis prescribed by Chapter 7 (commencing with Section 12700)of Division 5 of the California Business <br /> Professions Code administered by the Division of Measurement Stondaros of the California Deportmeni of Food and Agriculture <br /> MANIFEST # 721D213 NET AMOUNT <br /> TRUC1' # 9A93261 <br />' •O• # NONE TENDERED <br /> TRAILER # 1WD9397 <br /> SchedLlle 24 hOL1r5 an advance directly with the landfill . CHANGE <br /> Call (20Q )Q82-4299 to schedule. <br />' Drive Safe 1 y I I CHECK NO <br /> t ��� <br />' DRIVER'S SIGNATURE recycled paper <br /> i <br /> I , <br /> I <br />
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