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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
Scanner
WNg
Tags
EHD - Public
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Waste No 854320 <br /> Systems TM <br />)WNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> i <br /> r .\otY Curlpanx t S A Exon Station =7-2330 <br /> aerator Name Generating Location <br /> tress P 0 Bok 4415 Address 3128 11 Benjamin Holt Dr <br /> Houston Texas 77310-4415 S—tockton California <br /> ane No 2 1 G 8 7 0 0 Phone No 1� <br /> Waste Code C A 4 0 0 6 1 7 9 2 1 1 1 9 1 (T1 7 Containers Type <br /> Description of Waste Quantity Units No Type D - Drum <br /> 0 0 0 1 S C Carton <br /> S Bag <br /> NON HAZARDOLS T -Truck <br /> SOIL F-1 ❑ P Pounds <br /> Y - Yards <br /> F1 - F-10 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 fo Lsortat�Fpnaccording to applicable regulations <br /> erator Authorized Agen Name Signature Shipment Pate <br /> 510-634--6850 <br /> ck No Phone No <br /> Dillard Trucking Inc <br /> nsporter Name .._._ Joh #2. 55 Driver Name (Print) <br /> tress P 0 Boa 218 Vehicle License No /State + <br /> Bvion California 94514 1? \ <br /> Vehicle Certification 'J oo K'ri <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 the destination listed below <br /> er S11 <br /> nature Shipment Date Driver Signature Delivery ate <br /> DESTINATION <br /> D E I Casco Road Landfill <br /> Name Phone No <br /> 4001 \orth Masco Rd Livermore Ca 94550 <br /> dress <br />=reby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> homed A en€ Ss nature eceiPt Dat <br /> I ' <br /> f ' PASS CODE <br /> 36 <br /> BF1260 720 <br /> t- t Dt <br />
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