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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0506159
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Last modified
5/8/2020 9:47:20 AM
Creation date
5/8/2020 9:35:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0506159
PE
2950
FACILITY_ID
FA0007237
FACILITY_NAME
TRACY EXPRESS WASH & LUBE
STREET_NUMBER
2480
Direction
N
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95376
APN
21449002
CURRENT_STATUS
02
SITE_LOCATION
2480 N TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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I <br /> • ��D T` NON-HAZA4OUS WASTE MANIFEST <br /> WASTE TRE NT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE NO. L <br /> _ l y7 <br /> VERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> /) , / V, ) ,-j 9j ,L GLOVES ❑GOGGLES ❑RESPIRATOR []HARD HAT <br /> MAILING ADDRESS TY-VEK ❑OTHER <br /> �110 I � ' <br /> CITY, STATE, ZIP SPECIAL HANDLING PROCEDURES: <br /> PHONE <br /> CONTACT PERSON <br /> ��^ `- <br /> SIGN66RE OF AUTHORIZED AGE Tyam/ TITLE DATE <br /> WASTF-TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> AE J_ NOTES: TRUCK NUMBER <br /> ! <br /> ADDRESS I l Q41 <br /> )- / 7 i <br /> C'TY, STATE, ZIP <br /> PHONE END,D MP BOTTOM DUMP TRANSFER <br /> El <br /> SIG NATURE-OF`A THORIZED AGENT OR DRIVER DATEI ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> CUBIC YARDS <br /> FORWARD INC. LANDFILL 7,/ <br /> Forward shall have no obligation to accept the waste if weather or otherI <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPO AL METHOD: (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill. Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIO AERATE STOCKPILE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based onSOIL <br /> weather or other site conditions, Forward shall notify the Disposer when site LI <br /> conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> REMARKS <br /> ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> ATURE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> )rt 'lP r C r iA z(' `/ -/- ❑ OTHER <br /> HEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> EJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> SCHEDULE CALL(209)982-4298 MANIFEST # 49208 <br /> RAI Fs MPV <br />
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