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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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FIFTH
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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 /> INC. JOB ACCEPTANCE N0. ,�y N.7 <br /> GENERATOR REQUIRED.PERSONAL.PROTECTIVE-EQUIPMENT; <br /> i �FL30E/Zf�/L (9 � [-]GLOVESRESPIRA <br /> ^--�' ❑GOGGLES <br /> ❑ TOR ❑HARD HAT <br /> MAILING ADDRESS <br /> ❑TY-VEK ❑OTHER <br /> CITY,STATE,ZIP <br /> SPECIAL HANDLING PROCEDURES. <br /> l�iPo�,. CSL,F' 9�3G6 <br /> - PHONE • <br /> Oq7 61j5W <br /> CONTACT PERSON,. , <br /> SIGNATURE,OF AUTHORIZED AGENT/ TITLE DATEed / <br /> _-aim (����. I"Zi 5 <br /> WASTE TYPE <br /> -` RECEIVING FACILIT <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> 0 ❑ DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> s. ❑ OTHER MANTE.CA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> '2/0 `/-/ �`��`� s� (209) 952- 1009 FAX <br /> R * l <br /> NAME" ; $ s <br /> :,TRUCK-NUMBER <br /> . <br /> ADDRESS �C> <br /> �*b 9 C -3 3 87 <br /> . • CITY,STATE,ZIP <br /> PHONE END DUMP BOTTOM DUMP TRANSFER <br /> J;7-7b'- 41/06 C�-� ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VVAN " DRUMS <br /> ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC Y s <br /> Forward shall have no obligatiol 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 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 AE RATE STOCKPILE "OTHER <br /> waste for any reason. If Forward's refusal to accept the waste is based onOIL <br /> weather or other site conditions, Forward shall notify the Disposer when sit <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 TIC NU <br /> IYIBER ASBESTOS <br /> ❑ WOOD <br /> SIGN A RE OF RIZEDGENT DATE <br /> El ASH <br /> OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO .M. THE DAY PRIOR TO EXPECTED ARRIVAL • ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL ON OING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE, <br /> TO SCHEDULE CALL(209)982-4298 MANIFEST # 49603 <br /> GENERATOR COPY <br />
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