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CO0052663
Environmental Health - Public
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2500 – Emergency Response Program
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CO0052663
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Last modified
7/11/2023 1:49:57 PM
Creation date
7/11/2023 1:07:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0052663
PE
2546
FACILITY_NAME
BALWANT SINGH SANDHU
STREET_NUMBER
11616
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
19602014
ENTERED_DATE
9/21/2020 12:00:00 AM
SITE_LOCATION
11616 S HARLAN RD
RECEIVED_DATE
9/19/2020 12:00:00 AM
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\bmascaro
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EHD - Public
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POTRERO HILLS LANDFILL, INC. <br />Weighed at: <br />POTRERO HILLS LANDFILL, INC. <br />P.O. Box 68 <br />FAIRFIELD, CA 94533 <br />Deputy: Jaclyn Deleon <br />Vehicle ID?: 5-XP59929 <br />Reference: PHLF20971L <br />Haul Cust #: LATHROP LOAD <br />N <br />Route: <br />Trailer: HB1018 <br />Origin: LATHROP <br />DATE IN: 12/21/2020 TIME IN: 09:12:58 <br />DATE OUT: 12/21/2020 TIME OUT: 10:49:13 <br />Job: PHLF20971L <br />INBOUND TICKET Number: 01-1225743 <br />SCALE 1 GROSS WT. <br />SCALE 3 TARE WT. <br />NET WEIGHT <br />65660 LB <br />38920 LB <br />26740 LB <br />Qty Description <br />13.37 Profile Soil-T Disp <br />WEIGHMASTER CERTIFICATE: <br />THIS IS TO CERTIFY that the following <br />described commodity was weighed, <br />measured, or counted by a weighmaster, <br />whose signature is on this <br />certificate, <br />who is a recognized authority of <br />accuracy, as prescribed by Chapter 7 <br />(commencing with Section 12700) of <br />Division 5 of the California Business <br />and 'Professions Code), administered by <br />the Division of Measurement Standards <br />of the California Department of Food <br />and Agriculture. <br />X <br />(Deputy Signature) <br />This is to certify that this load does <br />not contain any hazardous materials, <br />medical waste or liquids of any type. <br />X <br />(Driver Signature)
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