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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
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WNg
Tags
EHD - Public
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1 <br /> Waste No 81- 4338 <br /> + Systems TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • <br /> C1 0.0n Clililr� +[ \ L S )-\ c C Iri <br /> nerator Name Generating Location <br /> Address P 0 Bar 4415Address 3128 TA Benjamin Fol t Dr <br /> 1 Houston l'e`as 77310-4415 Stockton Califninia <br /> Phone No ' 1 0 — 2 4 1 U 1 8 0 1 0 1 Phone No <br /> FI Waste Code C a 4 0 3 0 1 6 1 7 9 2 i 1 9 1 6 1 1 7 1 Containers Type <br /> Description of Waste Quantity Units No Type D - Drum <br /> 0 0 0 1 8 0 I C - Carton <br /> t3 - Sag <br /> NONSOI HAZARDOLS 1-1m F-1T -Truck <br /> SOIL P - Pounds <br /> Y' - Yards O- Other <br /> mF] 1 <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 for traoation according to applicable regulations <br /> r <br /> r <br /> 10 Ly./ 0 C & �LG <br /> nerator Authorized Agent Name Signature Shipment Date <br /> • <br /> 510-634-6850 <br /> Truck No Phone No <br />�ansporter Name Dillard Trucking Inc jbb m2 55 Driver Name (Print) �� �/" / /2 <br /> Address P 0 Bo% 218 Vehicle License No /State r `~ <br /> I <br /> Bvron California 9.3514 <br /> Vehicle Certification <br /> I hereby 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 to the destination listed below <br /> 7 <br /> /�// r L ,7 7 �J 7 <br /> na <br /> Iver slga Shipment Date Orwer Slgnaiure j Delivery Date <br /> M 1173 11 • <br /> lite Name B F I Vasco Road Landfill Phone No 5 1 0 — <br /> 4001 ?north fiasco Rd Livermore Ca 94550 <br /> dress <br /> ereby certify that the above named material has been accepted and to the best off n edge the foregoing is true and accurate <br /> r f <br /> R Authorized Agent SI nature receptoat <br />' PASS CODE <br /> 10/86 OF1260 720 <br />
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