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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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��ON-HAZARDOUS WASTE MANIFEST <br /> VIV WWW j4 ; WASTE TREATMENT AND DISPOSAL FACILITY <br /> FJOB ACCEPTANCEam <br /> QI:NE ig70 �'s� ;* EQU[RED}PERSONAL PROTECTN9 EOW101AENT <br /> GLOVES []GOGGLES❑ ❑RESPIRATOR C:]HARD HA <br />■ MAELING A �d�� _ -�r-�-�� ' - ❑TY-VEK ❑OTHER <br />' CITY,STATao�$-y-,7A-- 0�21�0SPECIAL HANDLING PROCEDURES <br /> _ <br /> _ter <br /> COMTAC7-PERSON1= <br /> �_.. � "`:,_-- - <br /> r AYMONDr MMKICITsEN <br /> SIG pf - M.ZED AGENT/ TITLE DATE <br /> a. it AQ J <br /> 4 :TEE TY _ - RECEIVING FACILITY 11-_ - <br />' • r.a• ❑ SLUDGE <br /> [Q•_REATI*FM,SOIL ❑ NON-FRIABLE ASBESTOS FORWARD INC LANDFILL <br /> DONSTRhJCTI L ❑ ASH 9999 SOUTH AUSTIN ROAD <br />�; ❑CONSTRICTION SOIL ❑ ASH <br /> # <br /> or rs [IOTHER -MANTECA, CALIFORNIA 95336 <br /> • �a <br /> GENERATI }IcJ 1C (209) 982-4298 PHONE -- -- <br /> y "1 AVENUE <br /> (209) 982- 1009 FAX <br /> NAMEDENBESTE TRZNSPORTpTION, 1NC NOTES1 ff TRUCK NUMBER <br />' ADDRESS q — < I <br /> 9 3� S c:=LCH RD #44 <br /> • ClTY STATII SOR, CA 95492 <br /> PHONE 707-838-1407 END DUMP 80TTOM DUMP IRAN R <br /> ❑ <br /> El <br /> SIGNATURE OF A�IQRiZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN UM <br /> _.FORWARD INC. LANDFILL CUBIC YARDS <br /> Forward shall have no obligation to accept the waste it weather or other s <br /> conditions impair the sate and effective disposal of the waste or if the waste DISPOSAL METHOD (TO BI~CCOMPLE @Y F y <br /> impairs the sate and effective operation of the Landfill Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the f DISADOSE BIQ - <br /> waste for any reason it Forwards refusal to accept the waste is based on 1i _ <br /> weather or other site condrhons.Forward shall notify the Disposer when site— SOIL <br />' c:ondrtrons are expected to change such that Forward will be able to a=Wt <br /> the waste ❑ SLUDGE <br /> KS <br /> REMAR _ . - <br /> - ----- s r_,_� , .��� _ ❑ NOW.FRIABLE <br /> ASBESTOS -- <br /> 1_vy <br /> FACILITY TICKET NUMBER <br /> _ T W C] wool) <br /> WOO <br /> SIGNAT�F AUTHORIZE _ _ DATE _ <br /> �/ �_ / i//// r - s r ❑ ASH <br /> OTHER <br />' SCHEDULING MUST-SE-MADE PRIOR TO 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 MANIFEST # C 9301 01 <br /> GENERATOFiCOPY <br />
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