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EHD Program Facility Records by Street Name
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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-HAZ .. ,DOUS WASTE MANIFEST <br /> FORWARD WASTE TREATMENT AND DISPOSAL FACILITY <br /> INC. JOB ACCEPTANCE NO. M - Z y G7 <br /> GENERATOR REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> �I S7`/ []GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> ti <br /> MAILING ADDRESS 7� �� ❑TY-VEK []OTHER <br /> V0 - b SPECIAL HANDLING PROCEDURES: <br /> CITY STATE,ZIP 1. <br /> . <br /> • PHONE <br /> • /07 37<1 <br /> �y7Z <br /> CONTACT PERSON <br /> 6716/,1,i4 <br /> ci�L a .. <br /> SIGNATURE OF"A/ULTH�iIZED GENT/TITLEDATE ' <br /> WASTE T`WE.. . ;. RECEMNG FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • Q DISPOSAL SOIL ❑ WOOD 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ❑ ASH <br /> •• ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY =: (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME. r - NOTES:. _ IRUCK-NUMBER <br /> ADDRESS <br /> . . CITY,.STATE, <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATUREOFAUTHO IZED GENTOR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> El 11 <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 M OD: (M BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill. Forward shall use <br /> reasonable efforts to promptly notity Disposer of its inability to accept the ,' DISPOSE l3P;':; AERATE SMI OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based on rpt <br /> weather or other site conditions, Forward shall notify the Disposer when site SOIL / <br /> • conditions are expected to change such that Forward will be able to accept <br /> the waste. ❑ SLUDGE <br /> • REMARKS rc <br /> • ❑ NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> • SIGNATURE OF AUTHORIZED AGENT DATE + <br /> ❑ ASH <br /> 7�,✓ ; I 1 !� ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4:00 P.M. THE DAY PRIOR TO EXPEC.ED ,ARRIVAL ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL.ONGOING DA1121 DELIVERIES MUST BE SCHEDULED 'WITH THE I-ANDF!LL HE DAY BEFORE. <br /> TO SCHEDULE CALL (209) 982-4298506 3 <br /> GENERATOR COPY MANIFEST * � <br />
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