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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 Paper — <br /> FORWARD, INC, NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> I <br /> 5146 <br />'Generator <br /> Address Z y4C 1�I112xi <br /> Phone (z4:v) P' - SS�S� -Contact <br /> Transporter �— <br /> Address S, 155-7-0en <br />'Phone Cbntact <br /> I hereby certify that the abov nam d aterial was picked up at the generator site listed above <br /> ".r, <br />'Driver Signature <br /> Shipment Date 9 <br />'Truck No V,7 131 q Load No <br /> Vehicte License No /State © 3� <br /> I <br /> sultant/Contractor `~ 7-.eu <br /> , <br /> 1fdress 7 J6 A 3 <br /> Phone ( ' ) - y� --Contacts D'C <br /> hereby certify that the above named material is consistent with the Information presented In the Waste Characterization Forrr <br /> and C o nta m I nated.SII Description Form,and has been prope rlydescribed,classified and packaged,and Is In pro per con ditior <br />�or transport ar-cgAirrgto applicable r ations <br /> Name f Date <br /> Destination Forward, Inc !r <br /> 9999 South Austin Road„Manteca, California 95336 <br /> (209) 982-4298 <br /> Received by � --�-' <br /> Date <br /> Acceptance No —_ - .2 0, <br /> this load contains soil with <br /> less than 100 ppm greater than 140 pprr <br /> PY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOF <br /> RY ALL LOADS MUST BE SCHEDULED AT LEAST 24 HOURS IN ADVANCE (209)882-4298 LANGFILL DELIVERIES <br /> FUST BE SCHEDULED ON A DAIL BASIS ANY UNSCHEDULED LOADS MAYBE REFUSED AT THE GATE <br /> Yards Per this Load <br /> WHITE-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />
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