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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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T -- - ) Recycled Paper - T <br /> [::FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 515 <br /> Generator , <br /> Address <br /> Phone (2 ) - Contact <br />' Transporter <br /> 5 <br /> Address Uu <br />' Phone (Z�j ) — - --9-// Z - Contact <br /> I hereby certify that the above named material was picked up aL,tl e jgperator site listed above <br /> Dryer S+gnature / <br /> Shipment Date 1� _ 9 <br /> Truck No Load No — <br /> Vehicle License No /State <br /> "onsultant/Contractor �� n n Sr�PJ C--7-16 X) �� n <br /> loddress — :9.3 2 10 1""E S /.c 1 C� A 3 �1 = <br /> Phone (2,9C,) _S's// - d Contact <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Fo <br /> and Contaminated-Soil Description Form,and has been properly described,classified and packaged,and is in properconditi <br /> for transport acc! ding to applicabi7gulations , <br /> Narne / Date —2 <br /> Destination Forward, Inc <br /> 9999 South Austin Road, Manteca, California 95336 <br /> (209) 982-4298 , <br /> Received by r ` <br /> —r-Date <br /> -� - <br /> Acceptance No !9_ - --32Q_ <br /> This load contains soil with <br /> less than 140 ppm greater than 1100 pp <br /> r <br /> COPY OF THIS SHEET <br /> 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 /> MUST BE SCHEDULED ON A DAILY BASIS ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE: GATE <br /> Yards Per this Load Z - -- <br /> ' WHITE-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />
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