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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 3 0 2 A <br /> S]/stetTM <br /> BROWNING-FERRIS INDUSTRIES ES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> =7 <br /> Generator Name Generating Location <br /> Address P 0 Bo\ 4f Address 3128 titi [sen tarr;in Pion- Dr <br /> hout,totr Te,0, 7T310-441-_ <br /> Sto t.�r3n awl!f r)t iiia <br /> Phone No J 0 2 C 8 0IL <br /> Phone No <br /> BFI Waste Code 0 14 <br /> 0 ' 9 6 1 r Containers Type <br /> Description of Waste Quante Units No Type D - Drum <br /> 0 O 0 i Q t❑ 0 / rT I C- Carto <br /> S - flag <br /> INOIi HAZARDOUS T -Truck <br /> SOIL ETI ❑ m ❑ P - Pounc <br /> Y -Yards <br /> Elm ❑ O Other <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 properly described, <br /> classified and packaged, and is in proper condition for transportation according to applicable regulations <br /> Ckc& 6EM Pzu E=zS <br /> Generator Authorized Agent Name Signature Shipment Date <br /> 510-634-6830 <br /> Truck No Phone No <br /> Dillard Trurkint= Inr 2 �� <br /> Transporter Name Driver Name (Print) <br /> Address F 0 Batt 218 Vehicle License No/State��'�� ,. <br /> B ron California 9451 <br /> Vehicle Certification 7 <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered wit <br /> at the generator site listed above out incident to the destination listed below <br /> Drner 4gnature Shipment Date Dnyer Signature Delivery Date <br /> DESTINATION <br /> Site Name B F I Vasco Roaa Landfill Phone No � 1 — 4 - 0 4 g <br /> 4001 \or th %asro Rd L1t Fr more t.a 945_50 <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of m knowledge the foregoing is true and accurat( <br />' f Authorized Agent Sr nature ecer t�Datb � <br /> PASS CODE <br /> 10186 <br /> BFI26 <br />
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