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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 854314 <br /> Systems TM <br /> WNiNG-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> E*%%C,l Compal)% L S a E%\ori Station :;:7-3330 <br /> erator Name Generating Location <br /> ress P 0 Boa 4415 Address 3128 1% Benjamin Holt Dr <br /> Pouston Texas 77310-4415 Stockton California <br /> ne No ' 1 0 — 2 4 6 8 r 0 0 Phone No <br /> C A <br /> Waste Cade F4FO[ 5 1 0 1 6 I 1 7 9 2 1 1 9—L6 I 1 1 7 Containers Type Description of Waste Quantity Units No Type D - Drum <br /> C -Carton <br /> 0 0 0 1 a B - Sag <br /> NOL HAZARDOUS T -Truck <br /> SOIL ❑ m ❑ P _ pounds <br /> Y -Yards <br /> m ❑ O-Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 100 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 to proper Gond) old for Fans anon according to applicable regulations <br /> rator Authorized Agent Name Signature - \ shipment ate <br /> TRANSPORTER <br />�k No � � �� _ Phone No 510-634-6850 <br /> Dillard Trucking Inc / <br />�sporter Name dela2,cgg Driver Name (Pant) T -� `/ Ggt,J�PC►1C C <br /> Iress P 0 Bol 218 Vehicle License No/State 3V `_I <br /> Byron California 94514 r� 5 ; y � �� S <br /> Vehicle Certification <br /> reby certify that the above named material was picked up I hereby certify that the above named material was delivered with <br />'ie generator site listed above out incident to the destination listed below <br /> b <br /> r Signature Shipment Hate Driver Signature Delivery Date <br /> DESTINATION <br /> Name B F I Vasco Road Landfill Phone No 0 4 9111 <br /> 4001 \orth Pasco Rd Livermore Ca 94530 <br /> Iress <br />,reby certify that the above named material has been accepted and to the best 7ofmyVno ledge the foregoing is true and accurate <br /> oozed A ent Signature J r cetpt Date <br /> PASS CODE <br /> 6 <br /> BF1260 720 <br />
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