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REMOVAL_2016
Environmental Health - Public
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EHD Program Facility Records by Street Name
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KETTLEMAN
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8476
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2300 - Underground Storage Tank Program
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PR0541462
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REMOVAL_2016
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Entry Properties
Last modified
1/20/2022 10:02:31 AM
Creation date
1/20/2022 9:50:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
REMOVAL
FileName_PostFix
2016
RECORD_ID
PR0541462
PE
2361
FACILITY_ID
FA0023769
FACILITY_NAME
FAMILY RESIDENCE OF RODNEY D & LINDA D GAEDE
STREET_NUMBER
8476
Direction
E
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
8476 E KETTLEMAN LN
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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—-FORWARD LANDFILL -- <br />9999 S AUSTIN RD-AANTECA, CA 95336 <br />CUSTOMERO 0 9 4 7 6 <br />HAMILTON, TERRY <br />***PREPAY ACCOUNT*** <br />MODESTO, CA 95358 <br />Contract:4204170369 <br />Generator:RODNEY D GAEDE <br />SITE Y8 <br />TICKET 0 1224242 <br />CELL <br />WEIGHMASTER IN - Alexis M. OUT - Christina G. <br />DATE/TIME IN -3/16/17 12:3 5 pm <br />DATElrMMI PK / 17 12:54 pm <br />VEHICLE HAMILTON 1 <br />CONTAINER <br />REFERENCE <br />BILL OFLADING 3689462 <br />SC4,LE IN GROSS WEIGHT 23,800 NET TONS 6.48 INBOUND <br />SCALE OUT TARE WEIGHT 10,840 NET WEIGHT 12,960 INVOICE <br />GTY. UNIT DESCRIPTION RATE mammuON TAX TOTAL <br />10.00 YD Tracking QTY <br />6.48 to SW -BENEFICIAL REUSE Origin:LODI 100% <br />1.00 ENVIRONMENTAL FEE 1 <br />1.00 FUEL RECOVERY FEE <br />The undersigned Individual signing this document on behalf of Customer acknowledges that he ahs hes roar and under ton d conditions CHANGE <br />on the rover" side and that he or she has the authority to sign this document on behalf of the cu tom <br />CHECK* <br />RS-F042UPR (07/121 SIGNATURE <br />
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