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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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Waste No 854323 <br /> Systems TM <br /> AWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> Fe,ator Name <br /> �:N%011 CDmpant ; 5 i_.•n , Station r7-3330 <br /> Generating Location <br /> 3ress P U Boy. 4415 Address 3128 k Benjamin Holt Dr <br /> Houston Texas 77310- €417, Stockton California <br /> 7ne No 0 1 0 1 0 �— <br /> Phone No <br /> Waste Code 0 6 1 7 1 9 2 1 9 6 1 1 7 Containers Type <br /> Description of Waste Quantity Units No Type D - Drum <br /> 00 0 1 8 ❑1' 0 1 E B " Barton <br /> NON HAZARDOUS T - Truck <br /> SOIL ❑ � P _ Pounds <br /> Y - Yards <br /> ❑ m F10- 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 to proper cond Pon fo trtaiton according to applicable regulations <br /> r � <br /> f � <br /> erator Authorized Agent Namb� Signature Shipment IDate <br /> • <br /> 510-634-6850 <br /> ck No Phone No <br /> Dillard Trucking Inc f! <br /> nsporter Name _Tah =2l/5 Driver Name (Print) ,-,_l� <br /> Press P 0 Bok 218 Vehicle License No /State U E rn(6 <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 generator si e listed above out incident to the destination listed below <br />�r ignature Shipment Date Drrve ature Delivery Date <br /> • <br /> Name B F I Vasco Road Landfill Phone No <br /> 4001 North Vasco Rd Livermore Ca 94550 <br /> tress <br /> i <br />�reby certify that the above named materiall5as been accepted and to the best of my knowledge the foregoing is tru ccurate <br /> orrzed A ent Sign aluReceipt Date <br /> PASS CODE <br /> 6 <br /> 13FI260 720 <br />
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