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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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— - kv Recycled Paper <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> ` 5151 <br /> Generator Pfd A <br /> Addresses C 1C iJ Toc�v� <br /> Phone (2.0 e� -�— <br /> .5.� � Contact <br /> 1 Transporter '� <br /> Address �x T <br /> �11� _ <br /> Phone ( -6ntact <br /> I hereby certify that t2abve nammaterial was picked up at the generator site listed above <br /> Driver Signature <br /> Shipment Date <br /> 'truck No i ' A' f Load No <br /> Vehicle License No/State <br /> nsultanUContractor <br /> 14 (14 <br /> .1111tudress; ' <br /> Phone (fir ) <br /> S 9 30 Cortact <br /> 1 hereby certify that the above named material is consistent with the Information presented in the Waste Characterization Fol <br /> and Contaminate�SailfDescription Form,and has been properly described,classified and packaged,and is in properconditt4 <br /> for transport acro i `to applicable re tions �+ <br /> Y9 <br /> Name - -e T w Date <br /> Destination Forward, Inc <br /> 9999 South Austin Road, ylanteca, California 95338 <br /> (209) 982-4298 <br /> Received by L -' <br /> Date <br /> Acceptance No - <br /> ' This load contains soil with <br /> less than 100 ppm _ greater than 100 op <br /> OPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FC <br /> _�JTRY 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 - - <br /> ' WHITE-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />
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