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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0506390
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Last modified
5/6/2019 1:33:42 PM
Creation date
5/6/2019 1:22:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0506390
PE
2950
FACILITY_ID
FA0007389
FACILITY_NAME
MINI STOP
STREET_NUMBER
244
Direction
W
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
13708014
CURRENT_STATUS
01
SITE_LOCATION
244 W HARDING WAY
P_LOCATION
01
QC Status
Approved
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EHD - Public
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�"'U�{1�19 �{ f NON-HAZARDOUS WASTE MANIFEST <br /> �� + ._ INCORPORATEWASTE TR ENT AND DISPOSAL FACILITY <br /> ' 4 JOB ACCEPTANCE N0. F771811 <br /> a[ 1+ RATOR - REQUIRED PERSONAL PROTECTIVE EOUIPMENT <br /> M&e Ah-Fat&E,my Mart ®GLOVES ❑GOGGLES [-]RESPIRATOR ®HARD HAT <br /> r <br /> ADDRESS. <br /> ❑TY VEK [:]OTHER <br /> Cwdyaa Road <br /> SPECIAL HANDLING PROCEDURES: <br /> S'G4TE,ZIP <br /> - H�caa,,CA 94524 � _ <br /> r <br /> - <br /> 747.2955 <br /> PERSON _ <br /> lU ~ DATE <br /> i4STE TYPE: - RECEWING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL C] NON-FRIABLEASBESTOS FORWARD INC. LANDFILL <br /> DISPOSAL SOIL ❑ WOOD <br /> CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ STOCK PILE ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> NI=RATInIGFACILITY (209) 982-4298 PHONE <br /> 249 Rad 1 -W" STOCK-m i (209) 982- 1009 FAX <br /> E TRALIC.# h TRUCK NUMBER <br /> 1,7 <br /> 7;75 <br /> ,ADRESS TRA LER LC.-# <br /> Past(Arme Bax S'•`9 /✓���7 <br /> CITY,STATE,ZIP TRAILER LIC.# <br /> Bvnln,C.194-514 <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> ..SIGNATURE OF.A, QED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS <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 DISPOSAL METHOD: (TO BE COMPLETED BY FORAMD) <br /> impairs the safe and effective operation of the Landfill. Forward shall use _ DISPOSE BIO AERATE STOCKPILE OTHER <br /> reasonable efforts to promptly notify Disposer of its inability to accept the _ <br /> waste for any reason. If Forward's refusal to accept the waste is based on <br /> weather or other site conditions,Forward shall notify the Disposer when site 1u <br /> conditions are expected to change such that Forward will be able to accept, <br /> the waste. ❑ SLUDGE <br /> `REMARKS <br /> ❑ NON-FRIABLE <br /> (FACILITY TICKET NUMBER ASBESTOS <br /> 1 ❑ WOOD <br /> ;SIGNATURE FUTHORIZED AGENT'� I DATE <br /> r ❑ ASH <br /> f t <br /> 'l�.•��t,. �f'S` `' ���� � � � � ❑ 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 TIME DAY BEFORE. <br /> TO SCHEDULE CALL(209)982-4298 r;` <br /> For(C95v iNH)s-es SALES COPY MANIFEST # C (1 1 f�G 2 <br />
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