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ARCHIVED REPORTS_XR0007768 CASE 2
Environmental Health - Public
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3500 - Local Oversight Program
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PR0544618
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ARCHIVED REPORTS_XR0007768 CASE 2
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Last modified
7/21/2020 8:42:19 AM
Creation date
7/21/2020 8:38:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007768 CASE 2
RECORD_ID
PR0544618
PE
3528
FACILITY_ID
FA0006456
FACILITY_NAME
SJ CO MOTOR POOL SHOP
STREET_NUMBER
444
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
15505005
CURRENT_STATUS
02
SITE_LOCATION
444 S WILSON WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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FORWAR D INCORPORATE D <br /> 9999 South Austin Road PO Box 6336 DATE 1g`_-= TE MANIFEST <br /> Manteca, CA 95336 Stockton,CA 95206 <br /> Landfill (209)982-4298 Fax(209)982-1009 Main Office (209) 466-4482 POSAL FACILITY <br /> ResourGs.Vasmi (209)982.4936 Fax (209)465-0631 <br /> CUSTOMER NO 1 J TRUCK NO BIN NO <br /> EQUIPMENT <br /> PIRATOR ,QHARD HAT <br />' BILL TO _. _ � � ..T .,.. i�±� '1 <br /> N SIZE YDS DESCRIPTION S PER YD $AMOUNT NOTES <br /> ❑REFUSE - <br /> C]TREATED WOOD <br /> ❑SLUDGE <br /> ❑ASH <br /> Q ASBESTOS <br />' 0 LYON FRIABLE ASBESTOS y <br /> !L <br /> PTO <br /> III SOIL <br /> O AERATION SOIL <br /> U AIB SOIL <br /> O Bio SOIL <br /> ❑CONSTRUCTION SOIL LANDFILL <br /> • <br /> TOTAL �USTIN ROAD <br /> = ' RNIA 95336 <br /> stg IN Li J�a.,� O <br /> GENERATINGFACILITY_ _ (209) 982-4298 PHONE <br /> (209) 982- 1009 FAX <br /> NAME NOTES _ TRUCK NUMBER <br /> ADDRESS <br /> • CITY,NATE,ZIP _ <br /> PHONE <br /> 1 T F- 1111 END DUMP BOTTOM DUMP TRANSFER <br /> _ - - - <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFFS) FLAT-BED VAN _ DRUMS <br /> j ❑ ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL C�YARDS <br /> ' Forward shall have no obligation to accept the waste if weather or other <br /> conditions impair the safe and effective disposal of the waste or If the waste DISPOSALMETHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shall use DISPOSE 810 AERATE STOCKP9LE OTHER <br /> reasonable efforts to promptly notify Disposer of Its inability to accept the <br /> waste for any reason If Forwards refusal to accept the waste Is based on O <br /> weather or other site conditions, Forward shall notify the Disposer when site <br /> • conditions are expected to change such that Forward will be able to accept <br /> ' the waste ❑ SLUDGE <br /> REMARKS NON-FRIABLE <br /> ASBESTOS <br /> FACILI C�ET NUMBER <br /> ^ ❑ WOOD <br /> - Si ATUR§4617 AVf HORDED AGENT DATE <br /> _ r 67,-- <br /> ASH <br /> OTHER <br /> SCHEDULING MUST BE MADE PRIO. 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 <br /> MANIFEST # 26145 <br /> GENERATOR COPY <br />
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