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2900 - Site Mitigation Program
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PR0505449
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Last modified
5/17/2019 10:12:09 AM
Creation date
5/16/2019 2:56:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
WORK PLANS
RECORD_ID
PR0505449
PE
2953
FACILITY_ID
FA0006730
FACILITY_NAME
CLAUDE C WOOD CO
STREET_NUMBER
681
Direction
E
STREET_NAME
LOCKEFORD
STREET_TYPE
ST
City
LODI
Zip
95240
APN
04905002
CURRENT_STATUS
02
SITE_LOCATION
681 E LOCKEFORD ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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NON-HAZt-,. aD0US WASTE MANIFEST <br /> FORWARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC <br /> JOB ACCEPTANCE NO. (,, m — <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> Z-41-� C LAJ []GLOVES ❑GOGGLES []RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS ❑TY-VEK [:]OTHER <br /> SPECIAL HANDLING PROCEDURES: <br /> CITY,STATE,ZIP ti <br /> • 2f L u/STf C'_. <br /> PHONE <br /> 7G7 37v 6y 7z <br /> CONTACT PERSON _ <br /> c. <br /> SIGNATURE OF AUTHORhMD AGENT/TITLE DATE <br /> ! WASTE TYPg� RECEIVING FACtUTY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITYy (209) 982-4298 PHONE <br /> c (209) 982- 1009 FAX <br /> NAME TRUCK NUMBER <br /> Lo�L�T. 04.19,E P/744'�i1LI PX-1S <br /> ADDRESS <br /> • CITY,STAT ZIP S <br /> PHONE END DUMP . _ u BOTTOM DUMP TRANSFER <br /> . , SIGNATURE OFED AGE OR DRIVER DATE '-ROLL-OFF(S) "--FLAT-BED VAN DRUMS <br /> FORWARD INC. LANDFILL cuBlc 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 DI POSAL M OD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill. Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the _ :. DISPOSE _BIO AERATE OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on SOIL <br /> weather or other site conditions,Forward shall notify the Disposer when site <br /> ' conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> • REMARKS .. _. - -. <br /> NON-FRIABLE <br /> _ ❑ ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> ❑ ASH <br /> - <br /> -<� ❑ OTHER <br /> SCHEDULING MUST 3E MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL s ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL 'UPON ARRIVAL.ONGOING DAIL`! DELIVERIES MUST 3E SCNEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE ;ALL 1,209) 382-4298 35059 <br /> GENERATOR COPY MANIFEST # <br />
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