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ARCHIVED REPORTS XR0001497
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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1649
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3500 - Local Oversight Program
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PR0544207
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ARCHIVED REPORTS XR0001497
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Entry Properties
Last modified
3/1/2019 2:37:09 PM
Creation date
3/1/2019 1:59:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001497
RECORD_ID
PR0544207
PE
3528
FACILITY_ID
FA0005237
FACILITY_NAME
N A GOTELLI TRUCKING INC
STREET_NUMBER
1649
Direction
E
STREET_NAME
CHANNEL
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15304021
CURRENT_STATUS
02
SITE_LOCATION
1649 E CHANNEL ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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PROWNING-i <br /> Waste -TT �12c- 16,1C 1009042 No 906021 <br /> Systems T"" NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> VII Cal tea l - _ ' S : " c rhanoc-1 Cr <br /> enerator Name _ Generating Location <br /> Fdress F QAddress <br /> Go' 5510= Stock- , , CE, <br /> - , <br /> _ � I <br /> tone No Y I I I Phone No FTT <br /> t j Containers Type <br /> =1 Waste Code - - <br />' Description of Waste Quantity Units No Type D - Drum <br /> El C - Carton <br /> 1 F�, B Bag <br />' Elm ❑ T Truck <br /> P Pounds <br /> Y Yards <br />' ❑ m 1:1O Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 1100 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or Ry applicable state law, has been properly described, <br />' classified and packaged, and is in proper condition fdr'transpo n acc rciing to applicable regulations <br /> 1 � _ <br /> nerator Authorized Agent Name Signatu a Shipment Date <br /> • <br /> I� � 5 <br />�ck No Phone No /1 ' j 1 <br /> 1 Er r F �1 <br /> nsporter Name - ` - _ Driver Name (Punt).-'V_`� <br />(dress ` 1 :71,1 r4i e%no 1, E,c r f.r <br /> Vehicle License No /State r <br /> Vehicle Certification <br /> lereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> t;,qerator sit steel,above out i= ent to the d tlnation listed below <br /> kveature / Shipment Date DKver Sigr4ature / Delivery Date <br /> IL <br /> f i <br /> DESTINATION <br /> iVame`Fasco Road Sane t_ai ,/ j andfz 11 Phone NoE 1 n —I -11 4 7 9 1 <br /> jdress <br /> I <br />�reby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> r <br /> e Authored A enl S nature Rec D e <br /> e ai at <br /> PASS cool= <br /> 13F1260 720 <br /> a`E IR 4,TO R � :rCn r-r . <br /> T is- <br />
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