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ARCHIVED REPORTS XR0000657
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 XR0000657
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Entry Properties
Last modified
2/7/2019 5:49:43 PM
Creation date
2/7/2019 3:38:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000657
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 691552 <br /> Systems <br /> IO <br /> T <br /> R ING-FERRIS! USTTRIIESNODI-HAZARDOUS SPECIAL WASTE /MANIFEST � <br /> 0 I <br /> Exxon Company U S A mon Station 57-3330 <br /> +^nerator Name Generating Location <br /> i <br /> uuress p 0 Box 4415 Address 3128 W Benjamin Holt Dr <br /> Houston Te,cas 77310-4.115 Stockton California <br /> hone No Phone No 1 - <br /> Waste Code mFTI Containers Type <br /> Description of Waste Quantity No T 00-Drum <br /> C <br /> 1 G-Carton <br /> B-BBag <br /> NON HAZARDCLS T -Truc* <br /> SOIL F, P-Pounds <br /> Y-Yards <br /> ❑ m ❑ O-Other <br /> I hereby certify that the above named material does not contain free liquid as de`ined 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 /> -11111116- ,.or Authorized Agent Name Signature Shipment Data <br /> 310-634-6840 <br /> ruck No Phone No <br /> Dillard Trucking Inc 2. 35 <br /> nsporYer Name Driver Name(Prin� A2� r.�r--.....� <br /> kddress P 0 BD?` 718 Vehicle License No/State �9 <br /> Bron California 94514 <br /> Vehicle Certification <br /> hereby certify that the above named material was picked up l hereby certify that the above named material was delivered <br /> with-he generator site listed above out incident to the destination listed below <br /> 7 11 <br /> er 5+gnat a — Shipment Date Driver Stgnaturb Delivery Dais <br /> J <br /> 111 ij� <br /> • <br /> r � <br /> a,co Road Phone No <br /> Name ---- _ —�_ - ---- <br /> 'Hdress <br /> -by certi'y that the above named material has been accepted and to the best of my nowledge the 'oregoing is true and accurate <br /> Dalr l <br /> OI Av*Ori7E6 AG�r+ $+c�nlluf0 Aeeeep--. <br /> s <br />
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