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ARCHIVED REPORTS_XR0006739
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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PACIFIC
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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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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 P$Per - <br /> R IDENTIFICATION FORM <br /> FORWARD, INC. NON-HAZARDOUS WASTE DRIVE <br /> -� 515 <br /> Generator �! <br /> Address Z /v C <br /> Phone (21* ) � - - L� Contact <br /> Transporter <br /> � <br /> Address G' T d f <br /> °Contact <br /> Phone ( 2r ' <br /> I hereby certify that the above named material was picked up at the generator site listed above <br /> Driver Signature <br /> Shipment Date F <br /> Truck No Load No <br /> Vehicle License No/State <br /> I <br /> nsultant/Contractor <br /> -� � K� <br /> ddress � <br /> Phone e ) - -- <br /> � Contact <br /> I hereby certify that the above named material is consistent with the information presented in the'Naste Characterization For <br /> and Contaminated Soli Description Form,and has been properly described,classified and packaged,anti ;s in proper conditic <br /> I for transport accorduog to applicable regulations <br /> Date <br /> Name <br /> i <br /> 1 <br /> Destination Forward, Inc <br /> I 9999 South Austin Road, Manteca` California 95336 <br /> (209) 982-4298 <br /> Received by ~` <br /> �]atP <br /> Acceptance No � - � <br /> IThis load contains soil with <br /> less than 100 ppm greater than 100 pp <br /> COPY 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 /> IN <br /> MUST BE SCHEDULED ON A DAILY BASIS ANY UNSCHEDULED LOADS MAY BE REFUSED AT THE GATE ^ <br /> Yards Per this Load - <br /> 1 WHITE-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />
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