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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
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Tags
EHD - Public
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m <br /> r Waste r! <br /> 1 No <br /> Systems TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name Generating Location <br /> Address ``° 4' ` Address 3128 t` bi ! ' ' ! ' �,i <br /> Phone No Phone No <br /> BFI Waste Code '' Containers Type <br /> Description of Waste Quandt Units No T pe D- Drum <br /> 1 ❑ , ( G- a <br /> ' 1, B - Bag <br /> T -Truck <br /> P - Pound <br /> Y -Yards <br /> I L] F-1m ❑ O-Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 26010 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 /> �j ' 2 <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER . <br /> 510-634-6850 <br /> Truck No Phone No <br /> Dillard l'ruckinQ Inc 2, 55)Transporter Name Driver Name (Prirj l Z// ZYL / - <br /> Address r 0 BD\ 18 Vehicle License No/State ;7 � <br /> Bron Calzfor-i,e 9401.1 <br /> Vehicle Certification <br /> hereby certify that the above named material was picked up I hereby certify that the above named material was delivered witr- <br /> at the generator site listed above out incident to the destination listed below <br /> � �/I± <br /> Driver agnature Shipment Date Driver Sig <br /> Delivery Date <br /> DESTINATION <br /> Site Name 8 F 1 Vasru Road i anaf ill Phone No —14 4 i 1 0 � 9 <br /> 1001 tion: l,`stcl Rd L: ea urt ;. 91 0 �- <br /> Address <br /> I hereby cer ify that the above named material has been accepted and to Ke best of m howled e-tKe-ioregoing Is true and accurate <br /> f Authorized A ent Signature Recet t Date <br /> Mr <br /> PASS CODE <br /> 10186 BFI2ro <br />
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