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ARCHIVED REPORTS_XR0006739
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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6230
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2900 - Site Mitigation Program
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PR0543479
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ARCHIVED REPORTS_XR0006739
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Entry Properties
Last modified
5/5/2020 10:38:48 AM
Creation date
5/5/2020 9:51:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006739
RECORD_ID
PR0543479
PE
2960
FACILITY_ID
FA0024679
FACILITY_NAME
CANEPA'S CAR WASH
STREET_NUMBER
6230
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
081360030
CURRENT_STATUS
01
SITE_LOCATION
6230 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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-, <br /> ® Recycled Paper �93- % r <br /> + rd 1 <br /> t <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 5350 <br /> Generator A i2 14 <br /> iAddress —1 ---2 ��1 r 1__ tJ , <br /> Phone (,Z(:;r7 ) – - - Sal Contact <br /> _73 <br /> Transporter AL <br /> -y <br /> Address <br /> 1 <br /> Phone Contact <br /> c, <br /> I hereby certify that the above named material was picked up_¢ttle girierator site listed above <br /> Driver Signature <br />' Shipment Date – 473 <br /> -- <br /> Truck No Load No <br />' Vehicle License No/State <br /> Consultant/Contractor r4 A A) �5=2CJfMAJ` <br /> Address <br /> Phone (zpg) Contact <br />' I hereby certity that the above named material is consistent with the information presented in the Waste Characterization Forr <br /> and Contam,nate Spil Descnption Form,and has been properly aescnbed,classified and packaged,and ism proper condltio, <br /> i for transport ac ing to applicable regrlations <br /> =-rz <br /> Name Date 3 — <br /> i <br /> Destination Forward, Inc <br /> t 9999 South Austin Road, MantgPa-,Californ)a 95336 <br /> (209) 982-4298 <br /> Received by <br /> Date 3= - <br /> � d <br /> Acceptance No / - 30 3 T <br /> 1 This load contains soil with <br /> less than 100 ppm greater than 100 ppr <br /> A COPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOI <br /> ENTRY ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE (209)982-4298 LANDFILL DELIVERIE <br /> MUST BE SCHEDULED ON A(DAILY BASIS ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE <br /> Yards Per this Load T --- <br /> WHITE-FACJUTY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />
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