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ARCHIVED REPORTS XR0000652
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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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
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WNg
Tags
EHD - Public
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m <br /> f Waste No ' <br /> 1 <br /> Systems TM <br /> 8 N1NG-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> Generator Name Generating Location <br /> Address P 6 - Address - 128 h Bell <br /> Phone No f r J Phone No �^ <br /> BFI Waste Code `" ' EEL:= 1 ' Containers Type <br /> Description of Waste Quantit Units No T pe D - Drum <br /> C! �� C -Carto <br /> B - Bag <br /> \0\ Ha<AROOL: ❑ m ❑ T -Truck <br /> SGIL <br /> P - Pounc <br /> Y -Yards <br /> FTT ❑ ❑ O-Other <br /> 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 /> ator Authorized Agent Name SignaturV Shipment Date <br /> TRANSPORTER <br /> 310--634-6850 <br /> Truck No Phone No <br /> Transporter Name Driver Name (Print) <br /> Address r 0 T-, 218 Vehicle License No/State <br /> B\i4t CullrCrrLl�, P4514 <br /> Vehicle Certification <br /> 1 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 fisted above out incident to the destination listed below <br /> FEE <br /> Dever S tl / Shipment Date or, r, Delivery Date <br /> �g� <br /> DESTINATION <br /> r ,asc o Road T_andf t 11 <br /> Site Name Phone No <br /> �C1f i Nr t th asro Rrt l ix ermc:c C p 941 . <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best ofmy kn"ledge the foregoing is true and accurst <br /> 9�ifame of Authonzed Agent Si nature / / Recei t D e <br /> PASS CODE <br /> 10186 BF12[ <br />
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