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ARCHIVED REPORTS XR0000657
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 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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y� <br /> Waste 140 691555 <br /> ystems _u NON-HAZARDOUS:SPECIAL WASTE MANIFESTSR. 41NG-FERRIS INpUSTitlES 6 <br /> Exxon Company U S.A. + �" ; Exxon Station i7--3330 ; <br /> C ieralor Name Generating i_ocation <br /> address <br /> F o Bo` 4415 Address 3328 W Benjamin Holt Dr <br /> Houston Texas 77310--4415 Stockton California <br /> 3 1 0 P <br /> Phone Na hone No <br /> F F= ContainersroDrum <br /> E 1 Waste Code L, 1_J E I ` —Description of Waste DuanU C q1�°—� YYPertonW4�It]` HAZ 4ltDOLS uck <br /> SOIL TT ❑ L ❑ P-Pounds <br /> L�� Y Yards <br /> [-E= ❑ m ❑ Q-Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CPR Part 260w10 or any applicable <br /> state law, is not a rrazardnus waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, <br /> classified and packaged ano rs in proper condition for transportation according to applicable regulations <br /> ' F(- Or~r/REQ / a 9 ! <br /> (,..orator Authorized Agent Name Signature Shipment Date <br /> O <br /> 5I0-633-rf3�o <br /> Truck No ! Phone No <br /> Dillard Trucking Inc 2155 kzrN <br /> rnsporter Name Driver Name (Print) <br /> ? 0 Box 218 5 V 1/064 C4 <br /> Address Vehicle License No l5tate <br /> Bron California 94514 4� a2 <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 g <br /> l i [EREDelivery Date <br /> i rer S,graturs Shipment Date Driver Signature <br /> �. Phi ne No _ <br /> e Name --- __ — --- -- <br /> ,l <br /> ]dress <br /> I I )y certity that the above named materia has been accepted and to the best of my knowledge the loregoing is true and accurate <br /> Flece-D. 1,116 <br />
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