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ARCHIVED REPORTS_XR0009703
Environmental Health - Public
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EHD Program Facility Records by Street Name
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7647
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2900 - Site Mitigation Program
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PR0505534
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ARCHIVED REPORTS_XR0009703
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Entry Properties
Last modified
3/31/2020 5:21:28 PM
Creation date
3/31/2020 5:00:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009703
RECORD_ID
PR0505534
PE
2950
FACILITY_ID
FA0006840
FACILITY_NAME
TOSCO SUPER T MARKET
STREET_NUMBER
7647
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
07748014
CURRENT_STATUS
02
SITE_LOCATION
7647 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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6� I <br /> NON-HAZARDOUS WASTE MANIFEST <br /> ARD ` ; I" • - w WASTE TREATMENT AND DISPOSAL FACILITY <br /> �f �` JOB ACCEPTANCE NO, <br /> GENERATQR - REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> THRI FT 0 1 L COMPANY f ❑GLOVES ]GOGGLES RESPIRATOR ❑HARD HAT <br /> I MAILING AD [:]RESPIRATOR <br /> BLVD ❑TY-VEK ❑OTHER <br /> CITY, STATLP2WE f CA .40240 - - SPECIAL HANDLING PROCEDURES <br /> PHONE 310_923-987,6 <br /> CONTACT PERSON - y <br /> R-AY :O2dD FFL—MRiCHSEN <br /> SIGNATUR&OFiAU ORIZED AGENT/-TITLE DATE <br /> I �`{,isn ,( 1 1r� <br /> a■ <br /> ATE TY FA c RECEIVING FACILITY <br /> C @ C I <br /> I c c c e e c c i ❑ SLUDGE <br /> Q JREATME24r SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> DISPOStkL FriPL I ❑ WOOD <br /> [:F`CONSTFUCT,0N SOIL ❑ ASH 9999 SOUTH AUSTIN ROAD <br /> ` . ❑ OTHER MANTECA, CALIFORNIA 95336 <br /> GENERAT1M1�f tT Or'u �oMP�I Y (209) 982-4298 PHONE <br />' r , <br /> '�" ' °AyC,��_ _1 �`` _ UE (209) 982- 1009 FAX <br /> TVrKw�r LY <br /> / 4A s <br /> ^C <br /> NAME NOTES TRUCK NUMBER <br />' ADDRESS .' <br /> �. u z�I <br /> 1 C <br /> R: v <br /> . CITY, STATVP ` { <br /> WI AFD S 0 R, ^.' 954 <br /> 5$9 2 Z,(,';✓' `i J^�i/! <br /> PHONE 70 7—838-14007 END DUMP BOTTOM DUMP q TRANSFER <br /> ❑ ❑ ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS - <br /> * __\ ? / i !. ) q <br /> FORWARD INC. LANDFILL CUBIC YARDS - <br /> Forwara shah have no oblz;abon to accept the waste if weather or other <br /> conditions impair the safe and ehective disposal of the waste or if the waste DISPOSAL METHOD (TO$E COMPLETED BY FORWARD <br /> impairs the safe and effective operation of the landfill Forward shall use } <br /> reasonable efforts to promptly ->ca:y Disposer of its inability to accept the DISPOSE BiO AERATE STCj. OTHER°E„ <br /> waste for any reason if Forwara s refusal to accept the waste is based on <br /> weather or other site conditions Forward shall notify the Disposer when site IL <br /> ■ conditions are expected to change such that Forward will be able toaQcept SLUDGE <br /> the waste - ` _ ❑ <br /> REMARKS <br /> ❑ NON-FRIABLE <br /> FACILITY K 1 UMBER - `'` - ASBESTOS <br /> r - V _ <br /> / ❑ WOOD <br /> SI Til (Lr AUTHO ED AGEVf DATE <br /> ❑ ASH <br /> ❑ OTHER <br /> SCHEDULING MUST BE MADE PRIOR TO 4,:60 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 MANIFEST # C 9292 <br /> GENERATOR COPY <br />
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