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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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Waste No 854399 <br /> SIstets TM <br /> IWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> teratorName CN\on ComDanv t S A r\\on Station =7 3,' 110 <br /> Generating Location <br /> cress P O Box 4415 Address 3128 h Benjamin Holt Dr <br /> Houston Texas 77310-4413 Stocl, tnt, California <br /> ne No [:=—I 0 -- 2 4 1 6 1 8 r 0 0 j Phone No — <br /> Waste Code C A 4 5 4 G 1 1 1 7 1 9 1 2 1. 1 9 f 1 7 Containers Type <br /> Description of Waste Quantity Units No T pe D - Drum <br /> mC - Carton <br /> 0 Q 0 1 8 E T B Bag <br /> NON HAZARDOUS ❑ � ❑ T -Truck <br /> SOIL III 111 P - PPounds ds <br /> Y -Yards <br /> F-1 ❑ O- Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 Jor 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 conditicip4ot ortation according to applicable regulations <br /> �r <br /> ll ( ff � <br /> L L`TC;L�ri � c0lJ C !t �L� ` `.L Q L 0 2 <br />,rator Authorized Agent Name Signature Shipment bate <br /> TRANSPORTER _ <br /> 510-634-6830 <br /> ck No TS Phone No <br /> Dillard Trucking Inc �i-. <br /> nsporter Name -- _ Driver Name (Print) I Z' �� �'� <br /> cress P 0 Box 218 Vehicle License No /State <br /> Byron California 94514 <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 /> he goner or site listed above out incident to the destination listed be w <br /> r Signature 'Shipment Date 0 <br /> 0nver Signature Delivery Date <br /> DESTINATION <br /> Name B F I Vasco Road Landfill Phone No 5 1 0 — 4 4 7 0 4=1 <br /> 4001 \orth Vasco Rd Li%ermore Ca 94550 <br /> cress <br />,reby certify that the above named material has been accepted and to the best of my knowled6e7 <br /> regoing is true and accurate <br /> --;- '�� / E <br /> onzed Agent Signature / ZDR�ecei <br /> PASS CODE <br /> 6 8F1260 720 <br /> C- .r <br />
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