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COMPLIANCE INFO_2020
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2200 - Hazardous Waste Program
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PR0538714
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COMPLIANCE INFO_2020
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Last modified
11/9/2020 2:15:13 PM
Creation date
10/9/2020 2:41:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0538714
PE
2220
FACILITY_ID
FA0022229
FACILITY_NAME
California Department of Fish and Wildlife
STREET_NUMBER
2109
STREET_NAME
ARCH AIRPORT
STREET_TYPE
RD
City
STOCKTON
Zip
95206
APN
17731020
CURRENT_STATUS
01
SITE_LOCATION
2109 ARCH AIRPORT RD STE 100
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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SITE SITE TICKET# CELL <br /> fARD LANDFILL -- <br /> 9999 S AUSTIN RD MANTECA, CA 95336 wEIGHMASTER <br /> CUSTOMER DATEfrIME IN bAT I E DU <br /> 002135 <br /> CALIFORNIA FISH & GAME VEHICLE CONTA <br /> KIM PAULSON <br /> STOCKTON, CA 95206-4941 REFERENCE <br /> Contract:4204y81392-1 BILL OF LADING <br /> Generator:California Department of Fish and Wildli 1808813 <br /> SCALE IN GROSS WEIGHT 6,320 NET TONS C.35 INBOUND <br /> SCALE OUT TkARE WEIGHT 5,620 NET WEIGHT 700 INVOICE <br /> QTY. UNIT DESCRIPTION RATE EXTENSION TAX TOTAL <br /> 5.00 YD Tracking QTY <br /> 0.35 to SW—ANIMAL Origin:STOCKTON 100% <br /> 1.00 ENVIRONMENTAL EEE 1 <br /> 1.00 FUEL RECOVERY FEE <br /> • <br /> TENDERED <br /> The undersigned individual signing this document on behalf of Customer acknowledges that he or she has read and understands the terms and conditions CHANGE <br /> on the reverse side and that he or she has the authority to sign this document on behalf of the customer. <br /> F H42UPR(07112) CHECK# <br /> SIGNATURE <br /> SITE FORWARD LANDFILL -- SITE Y8 TICKET# 1285003 CELL <br /> 9999 S AUSTIN RD —MANTECA, CA 95336 WEIGHMASTER <br /> IN — Alexis M. OUT — Christina G. <br />�USTOMER 0012136 1 <br /> DATEITIME IN IM DAT <br /> CALIFORNIA FISH & GAME 1/19/18 10:37 am ��1�/T18 10:51 arI <br /> KIM PAULSON VEHICLE BLACK TRUCK 1 CONTAINER <br /> STOCKTON, CA 95206-4941 <br /> EREFERENCE <br /> Contract:4204y81392-1 <br /> Generator:California Department of Fish and Wildli LADING 1808813 <br /> SCALE IN GROSS WEIGHT 6,320 NET TONS 0.35 INBOUND <br /> SCALE OUT TARE WEIGHT 5,620 NET WEIGHT 700 INVOICE <br /> QTY. UNIT DESCRIPTION RATE EXTENSION TAXI <br /> TOTAL YD Tracking QTY <br /> 0.35 to SW-ANIMAL Origin:STOCKTON 100% <br /> 1.00 ENVIRONMENTAL FEE 1 <br /> 1.00 FUEL RECOVERY FEE <br /> TENDERED <br /> The undersigned individual signing this document on behalf of Customer acknowledges that he or she has read and understands the terms and conditions CHANGE <br /> on the reverse side and that he or she has the authority to sign this document on behalf of the customer. <br /> CHECK# <br /> iS-F042UPR(07112) SIGNATURE � <br />
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