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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0526874
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
11/1/2018 1:28:00 PM
Creation date
11/1/2018 8:32:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0526874
PE
2960
FACILITY_ID
FA0018201
FACILITY_NAME
FORMER MOBIL SERVICE STATION 99-CAS
STREET_NUMBER
75
Direction
E
STREET_NAME
ALPINE
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
11514007
CURRENT_STATUS
01
SITE_LOCATION
75 E ALPINE AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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NON-F�RZARDOUS WASTE MANIFEST <br /> FRWARI? <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> Pvc. JOB ACCEPTANCE NO. <br /> GENERATOR. - T=HANDLING <br /> AL PROTECTIVE EQUIPMENT <br /> L7Q ;';u0ST=1? GGLES ❑RESPIRATORMAILING.ADDRESS ❑HARD HAT <br /> HER40 Asi — Avenge <br /> CITY STATE, ZIP CIAL PROCEDURES: <br /> • <br /> Los Gatos A _5030 <br /> PHONE <br /> CONTACT PERSON <br /> SIGNATURE OF AUTHORIZED AGENT/ TITLE DATE <br /> r +Lj}- f contractor 4/05 <br /> WASTE <br /> • WASTE TYPE., RECEIVING.FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> 5. . A ?11e (209) 982- 1009 FAX <br /> 3tcc:� r, <br /> NAME NOTES.17 NOTES. I TRUCKNUMBER <br /> -c/11'1 1:1Uf�C C.. 111Lt ll'JC. <br /> ADDRESS <br /> • CITY,STATE 70X �5 <br /> .PHONE <br /> - END DUMP . - BOTTOM DUMP TRANSFER <br /> SIGNATUREOFAtd1"tiORIZl=D.AGENTOR.DRIVER -DATE ROLLOFE(S) _ FLAT--BED -.VAN DRUMS <br /> ❑ ..._. - <br /> 11/14/95 ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cu6(GYARDs <br /> Forward shall have no obligation to accept the waste if weather or other <br /> conditions impair the safe and effective disposal of the waste or if the waste <br /> impairs the safe and effective operation of the landfill Forward shall use DISPOSAL <br /> SP (TO BE COMPLETED-BY'FOOTHER = <br /> reasonable efforts o promptly notify Disposer c its inability was to accept the DISPOSE BIG AERATE s=MLE. 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 accept <br /> the waste. ❑ SLUDGE <br /> REMARKS <br /> .. ❑ NON-FRIABLE <br /> FACILITY TICKET NUMBER ASBESTOS <br /> - ❑ WOOD <br /> SIGNATUREOF AUTHORIZED AGENT DATE <br /> *_ 0 ASH <br /> C ? :✓ I ! i C _ ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL (209) 982-4298 <br /> ... ...._.--- ---.- MANIFEST # A1 0A7 <br />
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