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ARCHIVED REPORTS_XR0010842
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0541431
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ARCHIVED REPORTS_XR0010842
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Entry Properties
Last modified
12/10/2019 9:46:07 AM
Creation date
12/10/2019 9:10:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010842
RECORD_ID
PR0541431
PE
2953
FACILITY_ID
FA0023745
FACILITY_NAME
DEBOER TRUCKING
STREET_NUMBER
201
Direction
W
STREET_NAME
FIFTH
STREET_TYPE
ST
City
RIPON
Zip
95366
APN
25935013
CURRENT_STATUS
01
SITE_LOCATION
201 W FIFTH ST
P_LOCATION
05
QC Status
Approved
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EHD - Public
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NUN-HAZARDOUS WASTEMANIFEST" <br /> f. ..., WARD, WASTE TREATMENT AND DISPOSAL FACILITY <br /> ll9l�. JOB ACCEPTANCE NO. <br /> GENERATOR? _ ; � REQUIRED PERSONAL PROTECTIVE EQUIPMENT!' '. <br /> 13PP,_ 'QGLOVES QGOGGLES [,]RESPIRATOR []HARD HAT <br /> MAILING ADDRESS:' �'--`-' *ti _ ❑TY VEK ❑OTHER <br /> CITY,etATOE,:'il P SPECIAL HANDLING PROCEDURES: <br /> R t <br /> PHONE <br /> CONTACT ERSON , <br /> SIGNATURE OF AUTHORIZED AGENT/.TITLE DATE: <br /> 5/3 6y& <br /> *� WASTE TYPE RECEIVING FACILITY ; <br /> ❑ SLUDGE <br /> • ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> • ❑ DISPOSAL SOIL ❑ 9999 SOUTH AUSTIN ROAD <br /> El CONSTRUCTION SOIL ❑ ASH ASH <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982_4298 PHONE <br /> z10 y-; s'r - s`C (209) 982-- 1009 FAX <br /> NAME NOTES: TRUCK NUMBER <br /> ADDRESS <br /> . . CITY, STATE,ZIP u r 'r <br /> ESTO <br /> . PHONE END DUMP BOTTOM DUMP TRANSFER <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED ,VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL cU»Ic 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 DISP SAL METHOD:' (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 POSE BIO i AERATE STOCKPILE :`OTHER <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 <br /> • conditions are expected to change such that Forward will be able to accep <br /> the waste. ❑ SLUDGE <br /> REMARKS <br /> ❑ NON-FRIABLE <br /> FACILITY,7ICKE NUMBS ASBESTOS <br /> �' ❑ WOOD <br /> SIGr UR�9`OF/A HORIZ AGENT DATE <br /> E] ASH <br /> % <br /> *� /. ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TOR.N. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRNAL O G DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL(209)982-4298 <br /> MANIFEST # 49601 <br /> GENERATOR COPY <br />
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