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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
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LSauers
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EHD - Public
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.' Recycled aper <br /> r <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 535E <br /> Generator r J 1 l <br /> Address XJ <br /> Phone (��) - _ r?��s _ Contact , <br /> Transporter <br /> Address 15 -233 C2.4 <br /> Phone ( �) _ _Z.LfQ_?� Contact <br /> I hereby certify that the abpve gAed materipa was picked up We-tTenerator site listed above <br /> Dever Signature <br /> Shipment Date 3 r <br /> Truck No t ( _...:..._ _ Load No <br /> Vehicle License No/State <br /> a nsultant/Contractor (24)g7`/�tf C71 D A) � <br /> ddress G A C <br /> Phone (\ 7 / - _ _�3> ,. Contact - (:2h'eZ 4j L6iz <br /> I hereby certify that the above named material is consistent with the Information presented in the Waste Characterization Fol <br /> and Contaminated Soil Description Form,and has been proper) described,classified and packaged,and Is In proper conditit <br /> for transport acdovIing to applicable regu io�s <br /> Name ' Date ' .! 3 <br /> ter' <br /> Destination Forward, Inc <br /> 9999 South Austin Road, M ar alifoTm 95336 <br /> (209) 982-4298 <br /> Received by ' <br /> Date <br /> Acceptance No T93 - U <br /> This load contains soil with <br /> less than 100 ppm greater than 100 pp <br /> 04COPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FC <br /> TRY ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE (209)982-4298 LANDFILL DELIVERIE <br /> IMUST BE SCHEDULED ON A D !LY BASIS ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE <br /> Yards Per this Load <br /> WHITE-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />
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