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ARCHIVED REPORTS XR0000652
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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B
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BENJAMIN HOLT
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3128
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3500 - Local Oversight Program
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PR0544112
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ARCHIVED REPORTS XR0000652
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Entry Properties
Last modified
2/7/2019 5:25:12 PM
Creation date
2/7/2019 3:35:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000652
RECORD_ID
PR0544112
PE
3528
FACILITY_ID
FA0005145
FACILITY_NAME
EXXON COMPANY USA
STREET_NUMBER
3128
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
09523002
CURRENT_STATUS
02
SITE_LOCATION
3128 W BENJAMIN HOLT DR
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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Waste No 7 ; r <br /> SystemsTM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> Generator Name Generating Location <br /> Address r n Fo% 441:F Address 3128 t► 5eviairlti dolt <br /> HuaSLWie --it, r2_u i-i! 5 5torKton ralifQrnaa <br /> Phone No A ! C Phone No ` <br /> BFI Waste Code � 0 1, 1 1 Containers Type <br /> Description of Waste Quandt Units No Type <br /> D - Drum <br /> C- a <br /> rtc <br /> lI B - Bag <br /> "O'N LAZAPDP OLS T -Trucl <br /> 50TL <br /> ❑ P - Pouni <br /> Y - Yard <br /> ❑ m ❑ O-Othe <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been property described, <br /> classified and packaged, and is in proper condition for transportation according to applicable regulations <br /> GREG- DFMARzo i -� .U� P 41 '�/ =_ <br /> Generator Authonzed Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> 510-634-fi850 <br /> Truck No Q _ . _—_ __.___ Phone No <br /> -,� ' <br /> Transporter Name Dillard Ttur�,ina Tri, 2 55 Driver Name (Print <br /> Address P 0 Bor 218 Vehicle License No/State {- I=rJ� _. <br /> Bron California 94514 <br /> Vehicle Certification <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered wi <br /> at the generator site listed above out incident to the destination listed below <br /> Drrrer Signature Shipment Dae Dhver Signature Delivery Dare <br /> DESTINATION <br /> Site Name P F I Vasro Roan Lanaf.z l Phone No E=_1 4 4 ' 4 ' <br /> 4001 0V0' l d s c o Fid Li\.er ntore Ca 94350 <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of my know dge thgotre� ng is true and accurst <br />` of Authonzed Agent S� nature ece t Dat <br /> PASS CODE <br /> 10186 / BFI2E <br />
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