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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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CHANNEL
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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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_ � 0 S <br /> Waste (� <br /> ��..-. �_�-��... _�s?F,T..�A c c r_ �-►1�� n h o n Z-^�w��....��.... -.�.�.�.. _No r;J 'G <br /> Systems TM <br /> BRNON-HAZARDOUS INDUSTRIES ' `�O` `�-HAZARDQUS SPECIAL WASTE MANIFEST <br /> • <br /> Mid Cal Leasinc Generating Location 1649 E Channel St <br /> eneraGenerator Name <br /> ti' ° 0 6c)>, 55101 Stockton , Ca <br /> do - ddress Address <br /> { <br /> -1 <br /> j�n, m <br />�hil ne Phone No Phone No - <br /> L"jj iL-JL�J 13 9 1 9 2 3 9 5 Containers r Type , <br /> BFI BFI Waste Cade D Drum <br /> _ Description of Waste Quantitya Units No Type r <br /> 17' C Carton <br /> t om <br /> D,aSel 'Cc�ntdrr,��,ate� So-tl B Bag <br /> I <br /> ;� T Truck <br /> ❑ m ❑ P Pounds <br /> I Y Yards <br /> t <br /> - ❑ m F-10 Other ' <br /> r' ! hf' I hereby certify that the above named material does not contain free liquid as defined b 40 CFE Part 260 10 or an applicable <br /> Y Y PP <br />' state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has beenrproperly described, <br /> ria classlfred and packaged, and is in proper condttion for transportation ccording to applicable regulations <br /> G <br /> I -- <br /> 3eni .,renerator AWhonzed Agent Name Signature Shipment Date <br /> ' 6 <br /> L <br /> ru' k�fYruck No Phone No a -n <br /> 1 � <br /> Tra Transporter Name ft r Fnvi rC lrrn; a 7 Ser^, , cis Driver Name (Print) 4L_ <br /> 3400 r�trrlCr `I:r-t `�i(� �f <br />�dc <br /> [ep'ddress. a - - - T = Vehicle License No/State 1 <br /> Vehicle Certification <br /> IhEi eb hereby certify that the above named material was picked up f hereby certify that the above named materia! was delivered with <br /> at t at the generator site listed above out incident to the destination I s`ted below <br /> nw Driver Signature Shipment Date Driver pgnature Delivery Date <br /> ,Alte Name 1PC Bel Sant -,a I, ={�, � l � Phone NO11Idl,: <br /> o Address arrnl Vascc) Fo,;-d t �r-rnor,e ra 9 " c90 <br /> t t <br /> JE, <br /> 1i hereby certify that the above named material has been accepted and to the best of my knowledge the ;regoing is true and accurate <br /> aVthcbfAuthonzed A en1 Sr nature ReCerol Date <br />' r PASS CODE <br /> !gfI 7!66 <br /> f ��JJJJ BFI260��6 <br /> ,r <br /> I GENERATOR RETAIN �� <br />
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