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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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����_ WAJRR- NONWZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSXL FACILITY <br /> JOB ACCEPTANCE NO. — %9� <br /> GENERATOR <br /> k JU-ZR LIDT;v y�_J, REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> MAILING ADDRESS ❑GLOVES ❑GOGGLES ❑RESPIRATOR HARD HF <br /> 40 Ashler Ave, ❑TY-VEK ❑OTHER <br /> CITY,STATE 7T Catos, SPECIAL HANDLING PROCEDURES: <br /> LGs CA 95030 <br /> PHONE v _- <br /> CONTACTPERSOtL . ` '/2Uru�z— <br /> SIGt9T✓IJRRE, OF AUTHORIZED AGENT/TITLE DATE <br /> y�COrltractcl li/?4/a <br /> 5 <br /> ' WASTETYPE-- . <br /> RECEIVING FACILITY" <br /> ❑ <br /> TREATMENT SOIL ❑ SLUDGE <br /> ' ❑ DISPOSAL SOIL ❑ HON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> ❑ CONsTRucnON s6tL C1 ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILFTY <br /> 75 E. AlDire Ave, (209) 982-4298 PHONE <br /> : tackton, �,'- (209) 982- 1009 FAX <br /> NAME <br /> ADDRESS. ) '� L' FF( <br /> - - TRUCK NUMBER <br /> 77CIN,�TEZJP <br /> /PHOI� � BOTTOMDUMP TRANSFER <br /> SIGNATURE OFA" - IOrZE GENTOR'DRIVER DATE ❑,`" ._FLAT-BED VAN DRUMS <br /> FORWARD INC. LANDFILL !q YARDS_ 17/? <br /> :Forward shall have no obligation to accept the waste if weather or other / X V <br /> conditions impair the safe and effective disposal of the waste or if the waste / 1 <br /> impairs the safe and effective operation of the Landfill. Forward shall use DISPOSAL METHOD. (TO BE <br /> waste <br /> efforts o promptly notify Disposer of its inability to accept the _ - COMPLETED BY"FORWARD) <br /> waste for any reason. If Forward's refusal to accept the waste is based on .IDISPOS .,BIO AERATE SIOCxaI1:E:. _OTHER'_ <br /> weather or other site conditions,Forward shall notify the Disposer when site OIL <br /> • conditions are expected to change such that Forward will be able to accept <br /> the waste. - <br /> REMARKS _..,._ . <br /> _.. ❑ SLUDGE <br /> FACILITY TICKET-NUMBER. ❑ NON-FR"LE <br /> �- - ASBESTOS <br /> SIGNATUREOFAUTHORIZEDGENT_ '` DATE El WOOD <br /> ❑ ASH " <br /> ❑ 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 /> GENERA T CR-COpY MANIFEST* d I Q n Q <br />
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