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ARCHIVED REPORTS_XR0008020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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W
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WEST
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3302
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3500 - Local Oversight Program
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PR0545872
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ARCHIVED REPORTS_XR0008020
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Entry Properties
Last modified
7/21/2020 4:18:12 PM
Creation date
7/21/2020 4:11:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008020
RECORD_ID
PR0545872
PE
3528
FACILITY_ID
FA0025947
FACILITY_NAME
JAYS MINI MART
STREET_NUMBER
3302
Direction
N
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95204
APN
11705037
CURRENT_STATUS
02
SITE_LOCATION
3302 N WEST LN
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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LSauers
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EHD - Public
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FORWAR* NON-HAZ48DOUS WASTE MANIFEST j! <br /> - INC O R-I' O R-ATE D WASTE TREATMENT AND DISPOSAL FACILITY , <br /> _ JOB ACCEPTANCE NO. r 64911. Jr <br /> glFNERp`TOR u _ - _ REQUIRED PERSONAL PROTECTIVE EOUIPMENT J <br /> Stodcto�q Yc�oletut4_GcaxtptaryGLOVES ❑ ❑GOGGLES RESPIRATOR RHARD HAT }` <br /> MAILING ADDRESS _ -__ -- - - _ MTY-VEK ❑OTHER I <br /> 1905 Naavvyy - SPECIAL HANDLING PROCEDURES <br /> CITYrSTATE,ZIP __ _ _ _ ` <br /> PHONE 1 - - -- - -- I <br /> - ,_ACT_PERSON v - <br /> SI NAi T UREP_ F AUTHORIZED AGENT/TITLE DATE <br /> A JL <br /> l r � <br /> WA _ Y RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL + <br /> * DISPOSAL SOIL ❑ WOOD I <br /> CONSTRUCTION SOIL [] ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERAT_IN RACiLITY _4 , r - __ (209) 982-4298 PHONE <br /> Katie.Swddaq CA <br /> 3300 Wed (209) 982- 1009 FAX <br /> ME4 '� _ _ _ TRACTOR LIC # {t.� t 5, TRUCK NUMBER I <br /> ADDED _RE 5 9, lj4FA1 <br /> TRAILER LIC # Gjr 1 Smarr(v;7 <br /> • CITY,S TE 7 Pte;`>'`� T_R_AILER L,IC # - <br /> • [.fj_ <br /> PHONx _ __ _ _ END DUMP BOTTOM DUMP TRANSFER <br /> I <br /> • - ', �I FAUTHORIZED AGENT-OR-DRIVER— DATE -�- ROLL-OFFS)- FLAT-BED )(AN DRUMS <br /> CUBIC YARDS <br /> FORWARD INC. LANDFILL' <br /> Forward shall have no obligation to accept the waste if weather or other I <br /> conditions impair the safe and effective disposal of the waste or if the waste DISPOSAL MI=T D, (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 _ w BIO AERATE STOCKPILE OTHER ; <br /> waste for any reason If Forward's refusal to accept the waste is based on ` <br /> weather or other site conditions, Forward shall notify the Disposer when site SOIL <br /> conditions are expected to change such that Forward/will be able to acc <br /> the waste <br /> ❑ SLUDGE <br /> ❑ NON-FRIABLE <br /> FACILITY TICKET_ WOOD NUMBfrR�— - --- s <br /> WOOD <br /> SIGNATU� —_F AU ORIZ DWAGENT DATE <br /> -- _ _ -' ❑ ASH <br /> ❑ OTHER <br /> I <br /> SCHEDULING MUST BE MADE PRIOR YO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE' <br /> SUBJECT TO REFUSAL UPON ARRIVALNGOI G DAILY DELIVERIES MUST BE SCHEDU�ED WITH THE LANDFILL THE DAY BEFORE <br /> TO SCHEDULE CALL(209)982-4298 GENERATOR COPY <br /> F01(C951 INH)6 96 MANIFEST # C 624673 <br />
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