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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 <br /> Systems TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name Generating Location <br /> Address r 0 BoN 441 Address 0128 " Fetl'an`lIi 1i. lt 1), <br /> ,aSLo^ TT73i0--4135 tot Kt-Ct3 --,j? _foTr1-1 <br /> G f'. i G C <br /> Phone No 1 0 �� Phone No <br /> BFI Waste Code '` ; 0 ' ) k ' L k 1 0 6 ' Containers Type <br /> Description of Waste Quantity Units No Type D- Drum <br /> G v rj 1 G ❑ C-B - BBag <br /> rtor <br /> ag <br /> S01 HAZ4RDOL5 F-1m F-1 Y - <br /> -Truck <br /> SOIL <br /> P - Pound <br /> Y -Yards <br /> F-1m 1:1O- 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 /> Generator Authorized Agent Name Signatur Shipment Hate <br /> TRANSPORTER, <br /> 510-634-685U <br /> Truck No f Phone No <br /> Dallas Trucking Inc 2 55 - <br /> Transporter Name Driver Name (Print)I Z <br /> Address P 0 Box 218 Vehicle License No/State -1 1< <br /> Bvron California 94514 S-5s r G <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 witl <br /> at the generator site listed above out incident to the destination listed below <br /> �z EE= <br /> I Dnv Signalure Shipment Date Drner Signature Delivery Date <br /> DESTINATION <br /> Site Name B F I Vasco Road Landfill Phone No 1 0 — } r O 1 4 1 <br /> 9 <br /> 4001 Nor"h \ ascu Efts' LiveirLore Ca 94531 <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best gay owldge the foregoing is true and accuratE <br /> 01 Authorized Agent S+ nature , ecei ate <br /> PASS CODE <br /> 101136 BFI26 <br />
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