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SITE HISTORY_FILE 1
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3500 - Local Oversight Program
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PR0541875
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SITE HISTORY_FILE 1
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Entry Properties
Last modified
3/16/2020 4:24:15 PM
Creation date
3/16/2020 2:06:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE HISTORY
FileName_PostFix
FILE 1
RECORD_ID
PR0541875
PE
2960
FACILITY_ID
FA0024017
FACILITY_NAME
CHEVRON SITE 306415
STREET_NUMBER
437
Direction
E
STREET_NAME
MINER
STREET_TYPE
AVE
City
STOCKTON
Zip
95202
APN
1392417
CURRENT_STATUS
01
SITE_LOCATION
437 E MINER AVE
P_LOCATION
01
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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JSysWaste` No. 71 5 0,3F <br /> tems TM <br /> FERRIS INDUSTRIES NON-HAZARDOUSN-HAZARDOUS SPEC•L_VVASTE MANIFEST <br /> BROWNING- <br /> GENERATOR <br /> Generator Name <br /> '= Generating Location <br /> Address <br /> . P. G. box 51:5 Address 437 E. `finer Axe. <br /> San Ramon, Ca. 94583 StOCFLGSI, CA <br /> Phone No. Phone No. <br /> � <br /> ContainersFDrum <br /> BFI Waste Code W r Description of Waste Quantity tl� T pe OYI E Non Hazardous Soil m El <br /> 1:1 m ElO-Other <br /> I = <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 condition for transportation according to applicable regulations. <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> 510-63.4-6850 <br /> Truck No. / Phone No. <br /> Dillard Trucking, Inc. 143/93 Driver Name (Print)_ <br /> Transporter Name <br /> Address <br /> p. o. Box 218 Vehicle License No./State <br /> Byron, California 94544 - �C���� <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 /> at the generator sited above. out incident to the destination listed below. <br /> Delivery Date <br /> Driver Signature Shipment Date Driver Signature <br /> DESTINATION <br /> Site Name <br /> B.F.I. Vasco Road Landfill Phone No. 5=—F,. 4=o <br /> 4 9 1 <br /> 4001 North Vasco Rd. , Livermore, Ca. 94550 <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> S'g <br /> Ragelpt Dale <br /> Name of Authorized Agent alure �( <br /> PASS CODE <br /> SF1260--' <br /> 10/86 <br />
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