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COBEUM9DI (2)
EnvironmentalHealth
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2500 – Emergency Response Program
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COBEUM9DI (2)
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Last modified
3/23/2022 2:49:56 PM
Creation date
3/23/2022 2:43:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COBEUM9DI
PE
2546
STREET_NUMBER
6540
Direction
S
STREET_NAME
AUSTIN
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
18109023
ENTERED_DATE
8/22/2021 12:00:00 AM
SITE_LOCATION
6540 S AUSTIN RD
RECEIVED_DATE
8/21/2021 12:00:00 AM
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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POTRERO HILLS LANDFILL, INC. <br />Weighed at: <br />POTRERO HILLS LANDFILL, INC. <br />P.O. Box 68 <br />FAIRFIELD, CA 94533 <br />Deputy: DOMINGO R <br />Vehicle ID?: P158 <br />Reference: PHL211071L <br />Haul Cust #: STOCKTON W/LINER <br />DriverOn?: N <br />Route: JOB#11-21-00450 <br />Trailer: REP31333767 <br />Origin: STOCKTON <br />DATE IN: 12/09/2021 TIME IN: 15:19:08 <br />DATE OUT: 12/09/2021 TIME OUT: 15:19:08 <br />Job: PHL211071L <br />INBOUND TICKET Number: 01-1334045 <br />MANUAL GROSS WT. <br />MANUAL TARE WT. <br />NET WEIGHT <br />80000 LB <br />51320 LB <br />28680 LB <br />Qty Description <br />14.34 Profile Soil-T Disp <br />WEIGHMASTER CERTIFICATE: <br />THIS IS TO CERTIFY that the following <br />described commodity was weighed, <br />measured, or counted by a weighmaster, <br />whose signature is on this <br />certificate, <br />who is a recognized authority of <br />accuracy, as prescribed by Chapter 7 <br />(commencing with Section 12700) of <br />Division 5 of the California Business <br />and Professions Code), administered by <br />the Division of Measurement Standards <br />of the California Department of Food <br />and Agriculture. <br />(Deputy Signature) <br />This is to certify that this load does <br />not contain any hazardous materials, <br />medical waste or liquids of any type. <br />X <br />(Driver Signature)
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