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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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1 <br /> Waste No 854313 <br /> ` Systems TM <br /> BRO%AY ING-FERRISINOUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> i - Exxon Company U S A Exxon Station *7-3330 <br /> Generator dame Generating Location - - <br /> t$��jJY <br /> Address P. 0. Box 4415 Address 3128 W. Benjamin Holt Dr. <br /> Houston, Texas 77310-4415 Stockton, California <br /> Phone No =0 _11-j4] 6 11 7 0 0 <br /> Phone No �T <br /> BFI Waste Code 0 6 1 7 9 2 1 9 6 1 7 Containers Type <br /> Description of Waste Quant Units No Type O-Drum1 01_ OL.0 1 8 �Y tI LJ C-Garton <br /> t---1--1 t--� B - Bag _ <br /> NON HAZARDOUST -Truck <br /> 3 - SOIL E] m ❑ P - Pounds <br /> Y Yards <br /> LI I Ll I ❑ m ❑ O Other <br /> f 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, ts'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 conditio tra ortatton according to applicable regulations <br /> _r _ r r <br /> �v `�� a � <br /> Generator Authorized Agent N me�, Signature Shipment Pate <br /> 510-634-6850 <br /> Truck No Phone No <br /> Transporter Name _ Dillard Tr ob t J c Driver Name (Print) `e'" T'�..'����-� <br /> - r <br /> Address P 0 Box 218 Vehicle License No /State U <br /> Byron, California 94514 / <br /> Vehicle Certification -7 <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with <br /> at thelisted abov out incident to the destination listed below <br /> gene tqr site <br /> F&F6_121 � 1 61 W <br /> Driver Signature Shipment Date Driver Signature Delivery Date <br /> i <br /> Site Name _ S F I Vasco Road Landfall Phone No a 1 0 LA <br /> — <br /> ' ' 4001 North Vasco Rd Livermore Ca 84550 <br /> Address <br /> hereby certify that the above named material has been accepted and to the best of my wledge the foregoing is true and accurate <br /> i <br /> of Authorized A ent Si nature RecetPt Date <br /> rw <br /> PASS CODE <br /> ,abs 131712130 720 <br />
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