Laserfiche WebLink
San Joaquin County <br /> Environmental Health Department <br /> 1868 E Hazelton Avenue, Stockton, CA 95205 <br /> (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd <br /> Public Works Waste Pickup and Transportation <br /> 1. Date: ) l Z d/ Z. CO 00 <br /> 3. Time: 4. EPA ID M CAS111111039 <br /> s. Transporter Registration #: 6148 <br /> 6. Reporting Party: ❑PW DSO CHP ❑Others: <br /> 7. Waste Pick-up Address: J otG t(pne <br /> 8. Destination: 7850 S R A Bridgeford, Stockton, CA 95206 <br /> 9. Containers i6. Waste <br /> # Quantity Size Description <br /> 1 <br /> �g'zllo�t isC�ze�' <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> ��. Emergency Contact <br /> Environmental Health Department: (209) 468-3420 <br /> ,2. Special Instructions and Other Comments <br /> ss. Signature: <br /> ia. Inspector Name:^ /!G ��/ `�! is.Title � ,� I _0 q^ate''i 5 4 �5�. <br />