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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 <br /> Waste No 854325 <br /> Systems TM <br /> BROWNING FERRIS tRDtJS7'RIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • <br /> erator Name 7%\car% Conjpan,� C S a t peon Station =i- 3330 <br /> Generating Location <br /> ddress P 0 Sox 4415 Address 3128 U Benjamin Holt Dr <br />' Pouston Texas 77310-4415 Stockton Calzfolnia <br /> Phone No =0 — <br /> 1 0 — 2 4 6 8 i 0 0 �— <br /> Phone No <br />'Fi Waste Code C A 4 0 5 O 1 6 1 1 1 7 1 9 1 2 1 1 9 6 1 r Containers Type <br /> Description of Waste Quantity Units No T pe D Drum <br /> 00 0 1 g a p C -Carton <br /> f I _ u B - Bag <br /> NON HAZARDOLS T Truck <br /> SOIL ❑ m ❑ P Pounds <br /> YYards <br /> y I TTI F-1m ❑ O 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 condition for transportation according to applicable regulations <br /> L ( L Sk1YJ LL.- � LInerator Authorized Agent Na a Signature IZ Shipment Date <br /> • <br /> 510-634-6$50 <br /> ruck No f Phone No <br /> Dillard Trucking Inc <br />�ansporter Name 1� =t9 155 Driver Name (Print) Y __ <br /> Address P fl Box 21$ Vehicie License No /State <br />' Byron California 94514 -100 x(/'- <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 /> Ithe generator site listed above out incident to the destination listed below <br /> ��V'10_1 ' - r' I(, I z Z 17 s z <br /> Iver Signature Shipment Date Drsver Ssgnature Delivery Date <br />'ite Name B P I Vasco Road Landfill Phone No <br /> 4001 North Vasco Rd Lixermore Ca 94550 <br /> fereby <br /> dress <br /> certify that the above named material has bee accepted and to the best knowl the fore oirrga is true and accurate <br /> 01 Authorized A ent 5c n ur�r- - r V..Sepl=Dale <br /> r <br /> PASS CODE <br /> 10186 SFI260 720 <br />
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