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SITE HISTORY_FILE 1
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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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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JSyWaste ' No. 715041 <br /> stems <br /> ERRIS INDUSTES NON-HAZARDOUS`SPECIAL. WASTE MANIFEST <br /> BROWNING-FRI <br /> GENERATOR <br /> ❑_NOCAL Markc-Ling !S6C.AL -LL4L10I, 4ii1 R; <br /> Generator Name Generating Location <br /> Address P. 0. Box 5155 Address 437 E. Miner Ave. <br /> San Ramon, Ca. 94583 Stockton, CA <br /> Phone No. ' 1 0 — 2 1 7 1 ? 2 3 6 8 Phone No. �� <br /> C A w = Containers Type <br /> BFI Waste Code m Units No. T pe D-Drum <br /> Description of WastQuantity 1� © C-Carta <br /> 8-Bag <br /> T-Truck <br /> Non Hazardous Soil m <br /> P-Pounc <br /> Y-Yards <br /> ��J m 0 O 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, isnot 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 <br /> for transportation according to applicable regulations. <br /> flrc� DJn30 <br /> Generator Authorized Agent Name ':Signature Shipment Date <br /> TRANSPORTER <br /> aI 510-634-6850 <br /> Truck No. Phone No. <br /> I <br /> i. Transporter Name Dillard Trucking, Inc. 143/93 Driver Name(Print) <br /> Address P. O. Box 218 Vehicle License No./State 3Xp�O6 C p <br /> Byron. -California -94544 <br /> i Vehicle Certification <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered wit <br /> at <br /> att the generator site listed above. out incident to the destination listed below. <br /> TU/1 Il��� r� Z t y 9� lA <br /> ! Delivery Date <br /> i Driver Signature Shipment Date river Signature <br /> DESTINATION <br /> Road Landfill Phone No. 5 1 0 — 4 4 7 <br /> Site Name B.F.I. Vasco <br /> 4001 North Vasco Rd., Live"to <br /> Address <br /> I hereby certify that the above named material has been owledge oregoing is true and accurat <br /> Name of Authorized A ent Receipt Date <br /> _PASSCODE <br /> BF12f <br /> 10186 <br />
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