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CO0053349 (2)
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2500 – Emergency Response Program
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CO0053349 (2)
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Entry Properties
Last modified
8/3/2021 2:46:13 PM
Creation date
8/2/2021 4:09:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0053349
PE
2546
STREET_NUMBER
6163
Direction
S
STREET_NAME
MOBLEY
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
18707001
ENTERED_DATE
1/28/2021 12:00:00 AM
SITE_LOCATION
6163 S MOBLEY RD
RECEIVED_DATE
1/28/2021 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\ymoreno
Tags
EHD - Public
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SITE SIIE TICKET I CELL <br /> FORWARD LANDFILL -- VIE IG(MASTER 153L63 — <br /> 9999 S AUSTIN RD MANTECA, CA 95336 - ChrTstina-G. <br /> CUSTOMER DATE/TIME IN [DATEfnMEOUT <br /> 009166 .// /P S CVEHICLENTAINED <br /> ACCOUNTS PAYABLE REFERENCE � `01. <br /> STOCKTON, CA 95203 p <br /> Contract:4204Y911178 BILL OFLAOIN2tp� LfQ—I0I°-nn1 r-inana _� <br /> Generator:PG&B. _ - _ _ 6001601 <br /> MANUAL IN (;ROSS WRTf;RT 34,560 NET TONS 0.74 INBOUND <br /> SCALE OUT TARE WEIGHT 33,080 NET WEIGHT 1,480 INVOICE <br /> OTY. UNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br /> 20.1:0 YD Tracking QTY <br /> 0,7. to SW-CONT SOIL Origin:FARMINGTON 100% <br /> i <br /> TENDERED <br /> The undersigned Individual signing this document on behalf of Customer acknowledges that he or she has read and understands the terms and conditions CHANGE <br /> on the reverse side and that he or she has the authority to sign this document on behalf of the customer. <br /> CHECKN <br /> RS-F042UPR(0419) SIGNATURE --- <br /> -- <br /> CELL <br /> - <br /> am 1531637 <br /> FORWARD LANDFILL -- <br /> 9999 S AUSTIN RD -MANTECA, CA 95336 WEIGHMASTEp <br /> Christina G. llJJTj <br /> CUSTOMER 009166 DATE/TIME IN2/1/21 11:03 am OATE/fIb1E1/21 11:36 am <br /> P S C VEHICLE CONTAINER <br /> ACCOUNTS <br /> ACCOUNTS PAYABLE PSC 305013 - <br /> STOCKTON, CA 95203 REFERENCE po # 178-1910-0017-j0494 <br /> Contract:4204Y911178 <br /> Generator:PG&E BILL of LADING 600 160 1 <br /> MANUAL IN GROSS WEIGHT 34,560 NET TONS 0.74 INBOUND 1 <br /> SCALE OUT TARE WEIGHT 33,080 NET WEIGHT 1,480 INVOICE JII <br /> OTY UNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br /> 20.(0 YD Tracking QTY <br /> 0.7 to SPI-CONT SOIL Origin:FARMINGTON 100% <br /> i <br /> TENDERED <br /> The undersigned individual signing this document on behalf of Customer acknowledges that he or she has read and understands the terms and condilions CHANGE <br /> on the reverse side and that he or she has Ilse authority to sign this document an behalf of the customer. <br /> CHECK# <br /> RC-F0420PR(04V19) SIGNATURE - - <br />
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