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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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FWN' WARD <br /> NON-HAZARDOUS WASTE MANIFEST <br /> WASTE TREATMENT AND DISPOSAL FACILITY <br /> II�JC„` JOB ACCEPTANCE �� �' � L. �M <br /> QYNERATOR : r <br /> REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> GLOVES GOG <br /> ,: ❑ ❑ GLES : RESPIRATOR HARD H <br /> MAILING ADDRESS �, . � �" ❑ AT <br /> ❑TY-VEK [:]OTHER <br /> CITY,STATE,ZIP " SPECIAL HANDLING PROCEDURES: <br /> r? <br /> PHONE <br /> _S>75:;. <br /> CONTACT PERSON:: <br /> WIT V.4sexf � <br /> SIGNATURE OF AUTHORIZED'.AGENT 1:,TITLE DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> ❑ SLUDGE <br /> ❑ TREATMENT SOIL <br /> • E] DISPOSAL SOIL E] NON-FRIABLE ASBESTOS FORWARD INC. LANDFILL <br /> ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (249) 982-1-298 PHONE <br /> �/U �� �F�-rF- S�`[-� <br /> (2 4 9) 982- 1009 FAX <br /> NAME` <br /> hIOTES: TRUCK NUMBER <br /> ADDRESSi c/� X14 i ti(L 014 !Zu C,rCr L o�q b #'r6 <br /> : : 0 <br /> • CITY,STATE,ZIP <br /> ST <br /> • PHONE END DUMP BOTTOM DUMP.: TRANSFER <br /> ❑ ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN DRUMS <br /> 7(C <br /> cf <br /> ❑ ❑ ❑ ❑ear-vv, >/��� _3� f./ <br /> FORWARD INC. LANDFILL cube 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 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 AERATE STDGKPtLE 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 'e SOIL ep <br /> • conditions are expected to change such that Forward will be able to ac i <br /> s the waste ❑ SLUDGE <br /> REMARKS <br /> 1 _ ElNON-FRIABLE , <br /> FACILITY CK-' <br /> K . �R ASBESTOS <br /> ❑ WOOD <br /> SIGN UR A T RIZED A IVT DATE <br /> ❑ ASH <br /> / ❑ OTHER <br /> i <br /> SCHEDULING MUST BE MADE PRIOR T 4:00 P.M. THE DAY PRIOR TO EXPECTED ARRIVAL ANY UNSCHEDULED LOADS ARE <br /> SUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> TO SCHEDULE CALL(209)982-4298 GENERATOR COPY 49607 <br /> MANIFEST # <br />
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