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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 854328 <br /> Systems TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • <br /> � Exxan Cos,,t�ast\ L S A <br /> erator Name Generating Location <br /> ddress P 0 Box 4415 Address 3128 k Benjamin Holt Dr <br /> Houston Texas 77310-4415 Stocktoa Cal�`oinzc <br />' S 1 — 2 4 f� 8 7 0 0 — <br /> Phone No �JI-0I� Phone No <br />�F1 Waste Code C A 4 fl 5 0 6 1 7 9 2 1 1-9-k 1 1 1 r 1 Containers Type <br /> Description of Waste Ouantity Units No Type D - Drum <br /> C - Carton <br /> 0 0 0 T18 1❑ 0 / F1 B - Bag <br /> \0'N H4ZARDOLS T - Truck <br /> SOIL F-1 F-1 <br /> ❑ P - Pounds <br /> Y - Yards <br /> ❑ �� ❑ O- Other <br /> 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 transportation according to applicable regulations <br /> kL <br /> enerator Authorized Agent Na a signature Shipment ate <br /> • <br /> 510-634-6850 <br /> ruck No Phone No / I <br /> * Z, <br /> transporter Name Dillard Trucking Inc Driver Name (Punt) CJ <br /> k, - <br /> Address P 0 Bol 218 Vehicle License No /State X- <br /> 1 Byron California 94514 <br /> Vehicle Certification m 2 7 Z 9 <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br />�t the gene atar ss isTcl above out incident to the destination listed below <br /> r <br /> river fgnature Shrpment Date Driver Signature Detivery Date <br /> DESTINATION <br />�ite Name B F I l-asco Road Landfill Phone No <br /> 4001 'north \Tasco Rd Livermore Ca 94550 <br /> Address <br /> hereby certify that the above named material has been accepted and to the best of my knowledge the foregoin rue and accurate <br /> e of Authorized Agent Si t re Receipt Date <br /> f ` J <br /> _ PASS CODE <br /> 10166 BF1260 720 <br /> s R w rte 3i"Ei1 <br />
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