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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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Y � <br /> I u _ <br /> FORWARD r SITE TICKET - GRID <br /> INCORPORATED 31 151072 D-98 <br /> 9 South Austin Road/WEIGHING LOCATION P O Box 6336 WEIGHMASTER <br /> lanteca, CA 95336 Stockton, CA 95206 V. PONCE <br /> dflll (209) 982-4298/WEIGHING LOCATION Main Office (209)466-4482 DATE IN TIME IN <br /> source Recovery (209) 982-4936 Fax (209) 465-0631 10/12/99 07: 50 <br /> 883400 DATE OUT TIME OUT <br />' ADVANCED GEO ENVIRONMENTAL 10/12/99 tB; 08 <br /> SILL LITTLE VEHICLE ROLL OFF <br /> 4005 N. WILSON WAY BACF HOE T3 <br /> STOCr TON CA 95205-2486 REFERENCE ORIGIN <br /> 8834c C.) MELBAR I DES F=ETROLEUM <br /> WL <br /> Scale 1 Gross Weight 59864--� LS Inbound _ Charge ticl et <br />' Manual Tare Weight 34600 LP <br /> Net Weight 25260 LES <br /> QTY UNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br />' 12. 63 TONS Class II Soil by Ton <br />&H MASTER CERTIFICATE THIS IS TO CERTIFY That the following described commodity was weighed measured or countea by o weighmaster whose signature is <br /> this certificate who is a recognized authority of accuracy as prescribed by Chapter 7 (commencing with Section 12700)of Owision 5 of the California Business <br /> d Professions Cooe administered by the Division of Measurement Standards of the Cotifornio Department of Food and Agriculture <br /> MANIFEST # 720215 NET AMOUNT <br /> TFUC} # 9C51 1070 <br /> P.O. # NONE TENDERED <br />' TRAILER # 1V05747 <br /> Schedule 24 hOurs in advance directly with the landfill . CHANGE <br /> Call (20c? )982-42Qe to schedule. <br /> tDrive Saf e l y f f CHECK NO <br /> 4IL 04 recycled paper <br />' DRIVER'S SIGNATURE <br /> 1 <br /> i <br />
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