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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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916
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2200 - Hazardous Waste Program
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PR0220091
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COMPLIANCE INFO
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Last modified
12/5/2018 10:43:28 AM
Creation date
11/6/2018 8:38:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0220091
PE
2228
FACILITY_ID
FA0002862
FACILITY_NAME
R V CIRCUITS INC
STREET_NUMBER
916
Direction
S
STREET_NAME
CENTER
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
14714036
CURRENT_STATUS
02
SITE_LOCATION
916 S CENTER ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS3\222IAError\IAError\C\CENTER\916\PR0220091\COMPLIANCE INFO\COMPLIANCE INFO.PDF
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EHD - Public
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;br ;�ua aoo IuOl <br /> vNOWHAZF—')OUSWASTE MANIFEST <br /> FORWAI�L, <br /> �:►' INCORPORATED WASTE TREg FAENT AND DISPOSAL FACILITY <br /> 4� JOB ACCEPTANCE NO. '; .l.;5 .f <br /> GENERATOR _. —.._. REQUIRED FERSONAL PROTEC EQUIPMENT <br /> -- <br /> - CIR�u L I S — &QVES OGOGGLES E3RESPIRATOR ❑HARD HAT <br /> MAI, NG ADDRESS. .' i::..:. ❑TY-VEK []OTHER <br /> �. •• <br /> CISTATE,ZlP +-. SPECIAL HANDLING PROCEDURES: <br /> ` TY, <br /> ;PHONE ,.: :.' .'. . <br /> 9... ... ........ ... <br /> SIGNATURE OF.AUTHORIZEDENT/.AGTfTLE _ DATE ,. . <br /> UMr' cVs4�� 87 ..6 : <br /> • WASTE E R.ECEM.NG FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBEsTVS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL IZ 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH ASH <br /> • 12 OTHER MANTECA, CALIFORNIA 95336 <br /> • p€�s�.„,,�,�,b.x-aro (J�s,uc <br /> GENERAnNGPTY.,; _ (209) 982-4298 PHONE <br /> Kv , Ctf2CUxT571-►.rC_ (209) 982-1009 FAX <br /> NAME _._ . ._...... . .... -- ...... TRUCK NUMBER <br /> ADDRESS:...—.. _._ ____.. .. ......:_.:---..... .. . ..,. .. . ._ : - <br /> PHONE — ...._.:__....... .:...._ `END❑DUMP.... ... _._..BOTTOMDUMP TRANSFER, . <br /> . <br /> SIGNAT RE OF AUTHCP4ZED AGENT OR DRIVER, DATE ROLL-0FF(S) ,• FLAT-BED _, ,VAN ;DRUMS .. _ <br /> FORWARD INC. LANDFILL &C1ARDS <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 a DBP.OSAL•METHOD:::;;• (TO-BE CAMPLETED BY FORVARD) <br /> impairs the safe and effective ooeretion of the Landfi0. Forward shall use - :. <br /> reasonable efforts to promptly notify Disposer of iia inability to accept the 1,4POSE .: BIO;,:: AERATE, STOdCPILE ,.OTHER_-.'. <br /> waste for arty reason. tf Forward's refusal to accept the waste Is basad on <br /> weather or other site conditions,forward shall notify the Disposer whm site ❑ Sc <br /> conditions are avected to charge such that Forward win be able to accept <br /> the waste. _ ❑ SWDGE <br /> NON-FRIABLE <br /> ASBESMS <br /> F/�CILffY'TIGKET•NUMBER <br /> _ — — —-- ❑ WOOD <br /> SIG NATURE_OF AL3THORIZED.AGEW':: — DATE_ ':;'�.• ` <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 MANIFEST 0 6 10 8 1- C <br />
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