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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1640
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2900 - Site Mitigation Program
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PR0542676
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COMPLIANCE INFO
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Entry Properties
Last modified
12/2/2020 11:18:44 AM
Creation date
7/27/2020 9:04:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0542676
PE
2953
FACILITY_ID
FA0024554
FACILITY_NAME
JOHNS, WILLIAM D
STREET_NUMBER
1640
Direction
N
STREET_NAME
BROADWAY
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
CURRENT_STATUS
01
SITE_LOCATION
1640 N BROADWAY AVE
P_LOCATION
01
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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BILL OF LADING <br /> Stericycle <br /> NVIKONMENTAL SOLUTIONS <br /> DELIVERY DATE JOB# <br /> SHIPP R G STOMER POINT OF CONTACT <br /> ADDRESS iPHONE# <br /> 1 (0 1--1 C) k '. 9 C-0a w 0,N I <br /> CITY STATE,ZIP — — <br /> S1 f—C <br /> CAARRRIEFT-/,�T,,RAN-SPPORTER Y/ (/ PHONE# <br /> % 714!1 lOY 1A ex-- /-^'n V11/o -1 n'[ _5�2,)t V t� o- -_�t 0 <br /> Mk'"E FAC! TY POINT OF CONTACT <br /> ADDRESS PHONE# <br /> Vii <br /> CITY STATE,ZIP <br /> U �L LO-7 — <br /> HM US DOT Description (including Proper hipping Name,Hazard Class,and 1D Number) Containers Total UOM <br /> No. Type Quantity <br /> D oc P <br /> special Handling Instruction and Additional Information: <br /> �VVx <br /> �l3a'Zs�r392� <br /> 'lacards Provided YES NO_ Emergency Phone B <br /> ;HIPPER'S CERTIFICATION:This is to certify that the above named materials are property classified,described,packaged,marked and labeled,and are in proper condition for <br /> ansportation according to the applicable regulations Of the Department of Transportation- <br /> SHIP R)PRI T OR TY E NAME SIGNAT E PAONTH I DAY YEAR <br /> 2ARUACIUTY) <br /> )PRINT OR TYPE NAME NAT E MONTH nav YEAH <br /> X (7 Z Za /7 <br /> CONSIGT OR TYPE NAME SIGNATU MONTH DAY YEAR <br /> � X <br /> JRM NO.209 REV 11/14_-. -_- ` ...`.'.-;r.e.^.•:.-.._ __._ __- <br />
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