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ARCHIVED REPORTS_XR0007768 CASE 2
Environmental Health - Public
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WILSON
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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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� � FORWgRD iNCORP <br /> 9999 South Austen Road ° q T E o { MANIFEST <br /> Manteca, CA 95336 O Box CA 9 DATE t ` ' r r ISAL FACILITY <br /> Landfill f209)982-4298 Fax(209)982-10()q Stockton CA 5206 1$ <br /> -dun al (209)982-4936 Main Office (209)466-4482 <br /> Fax (209)465-0631 <br /> _ CUSTOMER No 1' ( ; �( 1 QUIPMENT <br /> TRUCK NO - J 87N NO IATOR HARD HAT <br /> BILL TO <br /> (V SIZE YDS DESCRIPTIONS <br /> PER YD $AMOUNT <br /> © ❑REFUSE 1 <br /> NOTES <br /> �-..� o TREATED woos }} <br /> Q SLUDGE <br /> ASH + 1 <br /> ❑ASBE$TO$ J <br /> 17 NON FRIABLE ASBESTOS I <br /> O III OIL J <br /> Q AERATION SOIL <br /> ❑AJB SOIL <br /> F o�NS R'u�,°NSaiL [ANDFILL <br /> TOTA STIN ROAD <br />' 'A � r, RNIA 95336 <br /> Signed <br /> GENERATING FACILE INA.MjP 8 P H O N E <br /> P)6I,cG�/o��� (209) 982- 1009 FAX <br /> S � � <br /> NAME NOTES- TRUCK NUMBER <br /> ADDRESS _ ? �3 <br /> • CITY,STATE,ZIP _ <br /> . PHONE END DUMPP T <br /> BOT <br /> - TOM DUMP <br /> u6o�� - - ❑ -- - - ❑ <br /> SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE R -OFF(S) FLAT-BED VAN -DRUMS <br /> ❑� ❑ ❑ ❑ <br /> FORWARD INC. LANDFILL CUBIC YARDS _ <br /> Forward shall have no obligation to accept the waste If weather or other I <br /> conditions Impair the safe and effective disposal of the waste or If the waste DISPOSAL METHOD (TO BE COMPLETED BY FORWARD) <br /> impairs the safe and effective operation of the Landfill Forward shall use <br /> reasonable efforts to promptly notify Disposer of its inability to accept the DISPOSE 810 AERATE I STOCKPILE 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 Q- <br /> SOIL <br /> • conditions are expected to change such that Forward will be able to accept <br /> the waste ❑ SLUDGE <br /> REMARKS <br /> NON-FRIABLE <br /> ASBESTOS <br /> FACILITY TICKET NUMBER <br /> ❑ WOOD <br /> SIGNATYFI E of UT1 ORIZED GENT DATE <br /> ❑ ASH <br /> 1 ,2 <br /> ❑ OTHER <br /> SCHEDULING MUST 13E 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 <br /> DAY BEFORE <br /> TO SCHEDULE. CALL(209)!982-4298 MANIFEST # 26153 <br /> GENERATOR COPY <br />
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