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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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KETTLEMAN
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2900 - Site Mitigation Program
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PR0515037
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Last modified
2/6/2020 12:55:41 PM
Creation date
2/6/2020 11:37:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0515037
PE
2950
FACILITY_ID
FA0012023
FACILITY_NAME
ARCO STATION #434
STREET_NUMBER
501
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
03119028
CURRENT_STATUS
01
SITE_LOCATION
501 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Dillard Trucking, Inc. dba. SHIPPING ORDER <br /> 1Dillard Em ironmenta(Servkes FREIGHT BILL <br /> PO Box 579 <br /> ENTERED Byron, CA 9451409876 <br /> Telephone No. (925)634-6850 <br /> Facsimile No. (925)634-0569 <br /> Date a JOB NUMBERS(S) JOB NUMBERS(S) JOB NUMBERS(S) JOB NUMBERS(S) <br /> TRUCK , ,.. 1---- TRAILER # �J � # # # <br /> N0. � NO. /�— <br /> SUB. # # # # <br /> HAULER <br /> PRIME <br /> CARRIER CONSIGNEE <br /> GENERATOR(S) tQ�� � L-� �� DESTINATION <br /> 7',O 1 CITY j,!/�1" �.21t�7+f� �^ ��1'� <br /> CITY 1^ ©� c BEGINNING MILEAGE ENDING MILEAGE <br /> MATERIALS LOADING UNLOADING FUEL-GALLONS FUEL-VENDOR <br /> NO MANIFEST YARDS OR TIME TIME TIME TIME #1 #2 #1 #2 <br /> NO. WEIGHT ARRIVE LEAVE ARRIVE LEAVE <br /> 1 r6 Sys-� ? o Z, ,w to-14a#A 1 z pp, /9B7" <br /> 2 1�f d f �o PryPm yP�n 'f ll�°K <br /> 3 OFFICE USE ONLY <br /> a TNS/HR /L S/YDS <br /> 5 TRANSPORTATION UNITS: <br /> 6 TRANSPORTATION RATE: <br /> 7 SUBTOTAL: $ <br /> 8 <br /> 9 DISPOSAL UNITS: <br /> 10 DISPOSAL RAT <br /> 11 SUBTOTAL: $ <br /> 12 <br /> 13 BRIDGE-TOLL: <br /> COMMENTS: r f MATERIALS: <br /> 40xiv L a <br /> START STOPDEDUCT NET <br /> 71" TIME TIME <br /> DRIVER i. �'I <br /> D � <br /> �JL �Z2 [ e <br /> RECEIVE (r DATE APPROVED BY TOTAL CHARGES: $ <br /> TERMS and CONDITIONS <br /> Payment terms are net thirty(30)days subject to a charge of 1.5%per month on all past due balances.In the event the account becomes delinquent and It is necessary to institute <br /> legal proceedings,CUSTOMER agrees to pay DES'attorney's fees incurred in such proceeding,action or suit or in any appeal thereon.The parties agree that actions or <br /> proceedings arising in connection with this agreement shall be tried and litigated exclusively in the Courts located in Contra Costa County,California. <br />
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