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SITE INFORMATION AND CORRESPONDENCE
Environmental Health - Public
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EHD Program Facility Records by Street Name
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LOCKE
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12418
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3500 - Local Oversight Program
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PR0545391
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
3/5/2020 9:32:08 AM
Creation date
3/5/2020 9:03:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545391
PE
3528
FACILITY_ID
FA0009629
FACILITY_NAME
CALIFORNIA CEDAR PROD
STREET_NUMBER
12418
Direction
E
STREET_NAME
LOCKE
STREET_TYPE
RD
City
LOCKEFORD
Zip
95237
APN
051-320-05
CURRENT_STATUS
02
SITE_LOCATION
12418 E LOCKE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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r f VVdSLd No. <br /> t <br /> BROWNING-FERRIS INDUSTRIES I V V ' 1AZi--%n Dom/v J ,.i EC IAL WASTE E MANirES T <br /> • ' <br /> - ifornia i:�f'a:• arnc's�•*.; . <br /> Generator Name Generating Location " <br /> Address '2418 E. Locke Road Address 12418 E. Locke Road <br /> _ockeford. CA 95237 LOrkeford . CA 95237 <br /> s 1 a 1 019 <br /> Phone No. Phone No. <br /> SR Waste Code C ( a 4 0 5 0 1 2 1 1 1 2 1 9 3 =l 1 9 9T9 1 Containers Type <br /> Description of Waste Quantity Units No. T�yp.e,, 0-Drum <br /> 0 0 01 1 1 8 ❑ 0 1 1 21 C-Carlon <br /> L�� B -Bag <br /> NON HAZARDOUS T -Truck <br /> SOIL <br /> ❑ m ❑ P-Pounds <br /> Y-Yards <br /> ❑ m a O-Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, <br /> /classified and packaged, and is in proper condition for tr ortation according to applicable regulations. <br /> Pt20_aA("-t-S �v� L� 0 2 1 6 9 3 <br /> Generator Authorized Agent Name Slg Shipment Date <br /> TRANSPORTER' <br /> 510-634-6850 <br /> Truck No. Phone No. <br /> Dillard Truckincr. Inc. oge2T �O�/r� <br /> Transporter Name T n h :t?n? ? Driver Name(Print)- Cf <br /> Address P• 0. Bax 218 Vehicle license NoJState <br /> Byron. California 94513 <br /> Vehicle Certification - -- <br /> I hereby certify that the above n ed material:was picked up I hereby certify that th v arced material was delivered witt <br /> at the goner ite ' ted ve out i on o.tw diOnation sted below. <br /> 0 2 1 6 9 3 <br /> Drover Signature Shipment Dat• Driver Signature Dentary Da to <br /> DESTINATION <br /> Site Name B.F.I. Vasco Road Landfill Phone No. 5 1 0 — 4 4 7 0 4 9 1 <br /> 4001 North Vasco Rd. . Livermore. Ca. 94330 <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of m go regoing is ccurate <br /> Name of Authanzed Agent sl nature Mate <br /> PASS CODE <br /> t t71t38 BR260-7 <br /> TRANSPORTER RETAIN <br />
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