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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
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WNg
Tags
EHD - Public
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i � <br /> No <br /> Waste.-�-:�..--� .._ s C]� 1-..a 1�1 Y`r�_�f� ��-a 1 .. .1.�v=r ��.-�.»:._��-..—u�'r��i.. ..-;�...`���:� 5 0__ <br /> 1 Systems TM <br />'BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> rGENERATOA <br /> Generator Name Mid Cal Leasing Generating Location 1649 C ha n ri S; <br /> Address 0 iso, Address <br /> 55100 Stccktor, Ca <br /> i <br />'Phone No Ff 91 4 -16 6 1'0 9 <br /> A <br /> BFI Waste Code 4 1 0 5- E:D 11 8 9 -17 4 9 t Containers Type z <br /> � <br /> Description of Waste QuantityUnits No D - Drum <br /> pe <br /> C - Carton <br /> D-iese0nrarf,lriateJ" SC)I + ' � m T B Bag <br /> T - Truck <br /> M El ❑ P - Pounds' <br /> Y - Yards <br /> f �, _ � _ ❑ m_❑ 4- Other _ <br /> r <br /> t I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, , <br /> classified and packaged, and is in proper condition for-transportation-according to applicable regulations <br /> eneralor Authorized Agent Name Signature Shipment Date <br /> 0 <br />�fruck No !Z�7 Phone No <br /> f <br /> Transporter Name M TJ Env--tr4rinlcrt ay, ;a •vim ces Driver Name (Print) <br /> ddress Vehicle License No/S#ate <br /> Vehicle Certification <br /> hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the generator site listed above out Incident to the destination listed below <br /> (0 C7 2 Z' y I Zf <br /> Driver sig uff Shipment Date TFriver SIQ ature f r Delivery Date <br /> DESTINATION <br /> Ite Name V'7 scc P-ad Phone Ni. F T I— ` <br /> Address <br /> 4 �'s 1 �rY _r kcW�_i L-i - rrrol^� Ca 94550 <br /> hereby certify that the above named material has been accepted and to the best of my nnowledge the foregoing is true and accurate <br /> i <br /> f Authorized Agent Si nature Receipt Date <br /> , N i <br /> r <br /> ASS CODE <br /> 186 " BF1260 720 <br /> I <br /> GENERATOR RETAIN <br />
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