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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
Scanner
WNg
Tags
EHD - Public
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Waste No 854312 <br /> Systems TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • <br /> Cdd <br /> erator Name Generating Location <br /> ress P O Bo\ 4415 Address 3128 h Ben3aniin Holt Dr <br />' Fonston Te\as 77310-4415 Stir .11�n C� ifl�rl��a <br /> Phone No J 0 _ 2 1 4 1 £ 1 8 r 0 (t Phone No <br />�Fl Waste Code 1 0 6 1 7 9 2 1 9 G 1 7 Containers Type <br /> Description of Waste Quantity Units No Type D- Drum <br /> C Carton <br /> 0 0 0 L81 D 0 � j { [ B - Bag <br /> N0'� HAZARDOUS �� T -Truck <br /> SOIL ❑ � ❑ P - Pounds <br /> Y - Yards <br /> F-1m F-10- 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 In proper conditr� ation according to applicable regulations <br /> eneralor Authorized Agent Name Signature Shipmenf Date <br /> • <br /> i <br /> 510-63.1-6850 <br /> Truck No Phone No <br /> Dillard Trucking Inc <br /> ransporter Name _ g,�:.�'Le� _ Driver Name (Print), <br /> Address P 0 Box 718 Vehicle License No /State <br /> Byron California 94514 <br /> Vehicle Certification , _,70 C/ T.4 3 <br /> Lhereby certify that th bove named material was picked up I hereby certify that the above named material was delivered with <br /> gene a r s e I d above out incident to the destination listed below <br /> gnature Shipment Date Drwer Signature Delivery Date <br /> Site Name B F I Vasco Road Landfill Phone Na 1 5 1 1 1 0 — 4 4 'r 0 <br /> 4041 North \asco Rd L�,oermore Ca 94550 <br />(hereby <br /> ddress <br /> certify that the above named material has been accepted and to the best of my know" ee?the foregoing is true and accurate <br /> e of Authorised A eni Si nature Tlecerpl iia <br /> PASS CODE <br /> 10186 13F1260 720 <br />
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