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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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r Waste No 854327 <br /> Systems TM <br /> OWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • <br /> E\\011 Company l; S a E\\on StaL?oii =7-3330 <br /> neralor Name Generating Location <br /> dress P 0 Boa 4415 Address 3128 h Benjamin Holt Dr <br /> Houston Texas 77310-4415 Stockton California <br /> one No 1 0 — 2 4 G 8 7 0 0 �— <br /> Phone No <br /> I Waste Code _-� 0 6 1 r 9 2 1 9 6=7 Containers Type <br /> Description of Waste Quantity Units No Type D Drum <br /> i. C - Carton <br /> 0 0 0 1 8 ❑7 6 - Bag <br /> AOX HAZARDOUS �� T - Truck <br /> SOIL ❑ ❑ P - Pounds <br /> Y - Yards <br /> ❑ m F-10- 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, 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 for transportation according to applicable regulations <br /> i <br />----�� f <br /> tXCf-IJ iL '1� ; L 2 - - <br /> ierator Authorized Agent Name Signature `— Shipment Date <br /> TRANSPORTER <br /> 510-634-6850 <br /> ick No Phone No <br /> Dillard Trucking Inc -� <br /> insporter Name Job "2 /5.=� Driver Name (Print) <br /> dress P 0 Boa 218 Vehicle License No /State 71 lgv_�z <br /> Byron California 94514 ��,� <br /> Vehicle Certification <br /> ereby certify that the above named material was picked up I hereby certify that the above named material was delivered with <br /> the generator site listed above out incident t he destination listed below <br /> D 71 �16 a 7 <br /> ler Signature Shipment Date C6ver Signature Delivery Date <br /> DESTINATION <br /> e Name B F I Vasco Road Landfill Phone No 0 1 0 —L-41-41 x 0 4 9 , 1 <br /> 4001 North Vasco Rd Livermore Ca 94550 <br /> ldress <br /> ereby certify that the above named material has been accepted and to the best of my knowledge the-foregoing is true and accurate <br /> D a <br /> thonzed Agent Signature Receipt Date <br /> 0 <br /> PASS CODE. <br /> 86 <br /> BFI260 720 <br /> r <br />
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