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ARCHIVED REPORTS_XR0010357
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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S
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SUTTER
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2900 - Site Mitigation Program
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PR0543041
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ARCHIVED REPORTS_XR0010357
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Entry Properties
Last modified
5/18/2020 3:22:17 PM
Creation date
5/18/2020 2:52:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010357
RECORD_ID
PR0543041
PE
2960
FACILITY_ID
FA0024604
FACILITY_NAME
HUMAN SERVICES AGENCY
STREET_NUMBER
145
Direction
S
STREET_NAME
SUTTER
STREET_TYPE
ST
City
STOCKTON
Zip
95202
APN
14912016
CURRENT_STATUS
01
SITE_LOCATION
145 S SUTTER ST
P_LOCATION
01
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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' FORWARD, INC. NON-HAZARDOUS WASTE DRIVER IDENTIFICATION FORM <br /> 00934 <br />'Generator, j a �� r + ' <br /> Address <br />'Phone { 2Dyj } � - _�--� �� Contact My , /c2 r1 �Q Z-1404. <br />'Transporter s _ <br /> Address <br /> V(! <br />'Phone Contact <br /> I hereby certify th=tha�ove_named_q��-picked up at the generator site listed above <br /> Driver Signature <br /> Shipment Date <br /> Shipment <br /> No / 5J Load No <br /> ehicle License No /State (2 P )2 r <br />'Consultant/Contractor + <br /> Add ress Z <br /> Phone (� ; ) /7 Contact " <br /> I <br /> I hereby certify that the above named material is consistent with the information presented in the Waste Characterization Forrr <br /> and Contaminated Soil Description Form,and has been properly described,classified and packaged,and is in proper conditior <br /> for transport according to applic le regulations <br /> Name Y-rte }' + Date <br />' Destination Forward, Inc <br /> 9999 South Austin Road, Manteca, California 95336 <br /> (209) 982-4298 , d <br /> Received by " _� �1,r <br />' Date r <br />' Acceptance No <br /> p <br /> is load contains soil with <br /> less than 100 ppm greater than 100 ppn <br /> A COPY OF THIS SHEET MUST ACCOMPANY EVERY WASTE LOAD, AND MUST BE SUBMITTED AT THE GATE FOI <br />' ENTRY 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 />
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