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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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WNg
Tags
EHD - Public
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Waste No 854344 <br /> Systems TM <br /> IWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> t <br /> E%.on Coriipan% L S A Ftitot, `,tatinn =7-3130 <br /> terator Name Generating Location <br /> cress P 0 Boa 4415 Address 3128 h Benaan►in Holt Di <br /> Hous, on Texas 77310-4415 Stockton Calzfoinia <br /> 1 0 2 6 3 7 V [ <br /> ne No Phone No <br /> Waste Code C A 4 0 5 O 6 1 7 9 2 1 1 9 1 6 1 1 1 7 Containers Type <br /> Description of Waste Quantity Units No Type D Drum <br /> 0 0 0 1 8 P T❑ B garcon <br /> L—L� 9 <br /> NON HAZARDOUS T -Truck <br /> SOIL ❑ l� J ❑ <br /> P - Pounds <br /> YYards <br /> Flm El 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, 1s not a hazardous waste as defined by 40 CFA Part 261 or any applicable state law, has been properly described, <br /> Classified and packaged, and 1s in proper condit"fortransrtation according to applicable regulations <br /> J f r <br /> gator Authorized Agent Na a Signature - ` Shipment Date <br /> TRANSPORTER <br /> �] r 510-634-6850 <br /> ck No / Phone No <br /> Dillard Trucking Inc <br /> nsporter Name ,7 00 =2_ 5_�jDriver Name (Print) <br /> cress P 0 Bo\ 218 Vehicle License No/State <br /> Bron California 94514 <br /> Vehicle Certification �� r <br />,reby certify that the above named material was picked up I hereby certify that the above named material was delivered with <br /> he generator site listed above out incident to th `destination listed below <br /> It 8ignaEure ✓ Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> Name B F I tabco Road Landfill Phone No 0 1 0 — 4 4 r 0 4 9 1 <br /> 4001 :forth Xasco Rd Li\e;more Ca 94550 <br /> iress <br />,reby certify that the above named material has been accepted and to the best of my*-towfedge the foregoing is true and accurate <br /> U <br /> onzed A enc 5i nature '� Rec ate <br /> Pr <br /> PASS CODE <br /> 6 BF1260 720 <br />
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