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ARCHIVED REPORTS_XR0010842
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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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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_ WARD NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> JOB ACCEPTANCE N0. r <br /> GENERATOR 'REQUIRED PERSONAL.PROTECTIVE EQUIPMENT <br /> .(�,E e 04-2— C U5(� ❑GLOVES ❑GOGGLES ❑RESPIRATOR ❑HARD HAT <br /> MAILING ADDRESS ❑TY-VEK ❑OTHER <br /> 0 <br /> CITY,.STATE, ZIP ; c SPECIAL HANDLING PROCEDURES: <br /> PHONE <br /> CONTACT-PERSON <br /> � izrzrr V14NRIEF <br /> SIGNATURE.OF AUTHORIZED;.AGENT./-TITLE DATE <br /> WASTE_TYPE r M RECEIVING.FACWTY u. �t w d W <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> r <br /> • ❑ DISPOSAL SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ CONSTRUCTION SOIL ASH <br /> .• ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4208 PHONE <br /> :_21 v W, _g (209) 982- 1009 FAX <br /> 2,PO c,4 <br /> NAMENDTES: TRUCK NUMBER <br /> ADDRESS C f�r7��1 <br /> C-774)l�( `T f�UC/C/� L01�✓� � 1 <br /> I t •� <br /> `. CITY, STATE,,ZIP/ <br /> . PHONE END DUMP" BOTTOM DUMP TRANSFER <br /> Er� El El <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT=BED -VAN DRUMS <br /> "` ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YA S .. <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 DISP05 L T D: ; (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 Bl0 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 acce <br /> the waste. ❑ SLUDGE <br /> REMARKS � '... ... ` <br /> ❑ NON-FRIABLE <br /> FACILITY ETk3 BASBESTOS <br /> ER <br /> � El WOOD <br /> SIGN IrIRE THOMZ�D A T DATE <br /> { // / ❑ ASM <br /> OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 M. THE DAY PRIOR TO EXPECTED ARRIVAL r ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL O G DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL(209)982-4298 GENERATOR COPY MANIFEST # 49602 <br />
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