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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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-— - — { Hecycied Paper i <br /> FORw v, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 515 <br /> 6 <br /> Generator <br /> Address r <br /> XAliLdA <br />' Phone {L7e <br /> r Contact <br />' Transporter C K <br /> f� ! <br /> Address <br />' Phone (Zo< ' ) - '=' � — Contact <br /> I hereby certify that the above named material was,picked up at the generator site listed above <br /> Driver Signature �7 <br /> Shipment Date '– <br /> Truck No Load No S <br /> Vehicle License No/State <br /> nsultant/Contractor <br /> dress 1h AL2 <br /> 9 S �G d/ _Contact ' �J a <br /> Phone (7,0 j - <br /> I hereby certify that tie above named material is consistent with the information presentee in the Waste Characterization For <br /> and Contaminated`S Description Form,and has been properly described,classified and packaged,and is in proper conditu <br /> for transport accopd g to applicable re�ulations X-7l Date -a -` 7 ? <br /> Name �� <br /> 1 f r <br /> Destination Forward, Inc �^ <br /> 9999 South Austin Road, Mata, California 95336 + <br /> (209) 982-4298 <br /> Received by <br /> Date <br /> Acceptance No <br /> ' This 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 FG <br /> TRY ALL LOADS MUST BE SCHEDULED AT EAST 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 /> WMTE-FACILITY COPY YELLOW-TRANSPORTER COPY PINK-GENERATOR COPY <br />
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