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ARCHIVED REPORTS_XR0005021
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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MOFFAT
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983
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2900 - Site Mitigation Program
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PR0507952
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ARCHIVED REPORTS_XR0005021
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Entry Properties
Last modified
9/16/2020 1:15:01 AM
Creation date
3/17/2020 2:01:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005021
RECORD_ID
PR0507952
PE
2950
FACILITY_ID
FA0007846
FACILITY_NAME
OLYMPIAN CFN
STREET_NUMBER
983
STREET_NAME
MOFFAT
STREET_TYPE
BLVD
City
MANTECA
Zip
95336
APN
22115006
CURRENT_STATUS
01
SITE_LOCATION
983 MOFFAT BLVD
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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NON-HAZARDOUS WASTE MANIFEST <br /> FORWARD <br /> 1 N C O R P O R A T E D WASTE TREATMENT AND DISPOSAL FACILITY <br /> ' JOB ACCEPTANCE N0. <br /> ENERAT _I -- 1 , I/-, REOUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> #' <br /> + t `- ~s,� ; .�+ GLOVES ❑GOGGLES [:]RESPIRATOR b4_4D HAT <br /> MAILING ADQRESS ❑TY-VEK ❑OTHER <br /> CITY,STATE, �,�'y�i�. <br /> ZIP r- 4 SPECIAL HANDLING PROCEDURES <br /> PHONE <br /> CONTACT PEi SPN <br /> SIGNATURE OF AUTHOR <br /> ORIZED AGENT/ TiTLE� DATE <br /> WASTE TYPE RECEIVING FACILITY <br /> r <br /> ❑ TREATMENT SOIL SLUDRE <br /> NOS ABLE ASBESTOS FORWARD INC LANDFILL <br /> ❑ <br /> ❑ DISPOSAL SOIL ❑ WOOD <br /> ❑ CONSTRUCTION SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERATING FACILITY (209) 982-4298 PHONE <br /> {209} 982- 1009 FAX <br /> _ <br /> ME <br /> I NOTES _ TRUCK NUMBER- <br /> ADDRESS <br /> • CITY, STATE,ZIP " <br /> f�� {�� r._y <br /> PHONE { ;^y t ,Y END DUMP BOTTOM DUMP TRANSFER . <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVERDATE ROLL-OMS) FLAT-BED❑ VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> r <br /> FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the%,asle if weather or o'her <br /> conditions impair the safe and effective disposal of ,he waste or if the waste } <br /> impairs the safe and effective operation of the Landfill Forward small ose DISPOSAL METHOD, (TO BE COMPLETED BY FORWARD) <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE BIOAERATE STOCKPIik OTHER <br /> waste for any reason If Forwards refusal to accept the waste is based on <br /> weather or other site conditions Forward shall notify the Disposer when site : C3Solt- <br /> conditions are expected to change such that Fory and will be able to accept <br /> the waste <br /> REMIARKS _ SLUDGE - <br /> ❑ NON-FRIABLE <br /> FACILITY TICKET NUMBER ASBESTOS <br /> ❑ WOOD <br /> S GNATURE OF A O ED AGE14T 1 DATE <br /> ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4 00 P M THE DAY PRIOR TO EXPECTED ARRIVAL ANY UNSCHEDULED LOADS ARE <br /> IUBJECT TO REFUSAL UPON ARRIVAL ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE <br /> O SCHEDULE CALL {209}982-4298 <br /> SALES COPY MANIFEST 018 9 8 ) 2 <br />
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