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ARCHIVED REPORTS XR0009917
Environmental Health - Public
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EHD Program Facility Records by Street Name
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E
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EL DORADO
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7906
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2900 - Site Mitigation Program
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PR0540858
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ARCHIVED REPORTS XR0009917
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Entry Properties
Last modified
8/1/2019 1:46:38 PM
Creation date
8/1/2019 10:26:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009917
RECORD_ID
PR0540858
PE
2960
FACILITY_ID
FA0023360
FACILITY_NAME
ARCO SERVICE STATION #2130
STREET_NUMBER
7906
Direction
N
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95210
CURRENT_STATUS
01
SITE_LOCATION
7906 N EL DORADO ST
QC Status
Approved
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EHD - Public
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este _ L _ a No 1125878 <br /> Systems 4 , i <br /> ROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL']WASTE MANIFES- <br /> Generator Name ARCO PRODUCTS Generating Location ARCO STATION 1!2130 <br />'Address P.O. Box 5811 Address 7906 N. El Dorado Street <br /> San Xateo, CA 94402 Stockton, <br /> I� -TlICA <br /> Phone No �' 1�5 — 5 1 7 1 1 1 2 1 4 1 3 1 4 Phone No <br /> T-1 <br /> BFI Waste Code`t__�J k 0 511 <br /> 0 g fl 31 k 0 0 Containers Type <br />' Description of Waste Quantity Units No T e D-Drum <br /> C-Carton <br /> O o tZ 1 8 l�� I O_� T B -Bag <br /> NOMN HAZARDOUS SOIL T -Truck <br />' ❑ ❑ P -Poundf <br /> Y -Yards <br /> F-1 I I " La ❑ m 1:1 <br /> O-Other <br /> I hereby certify that the above named material does not contain free liquid-as defi ed b�140 CF art 260 1100 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any 2tpli le stat w, has been properly described. <br /> classified and packaged, and is in proper-condition for transportation according aple0a a regulations <br /> 1 <br /> nemWr Authonzed Agent Name _ Signature,;rrit, Shipment Date <br /> TRANS <br /> RTER <br /> �7 ' • <br /> Truck No ff _ Phone No. (510) 634-6850 <br /> Transporter Name Dillard Trucking,, Inc. 1004/36 Driver Name (Print)i Lr7l'j - W <br /> P.O. Sox 218 Vehicle License No/State � G�S3 <br /> Address j <br /> Byron, CA 94514 Vehicle Certification O l O! ?q 4 <br /> I hereby certify that the above named material was picked up l hereby certify that the above named material was delivered with <br /> at the generator site lis ve out incident to the destinatLon listed below <br /> 1 01Y d <br /> ver Signature Shipment Date r +gnatureDalhery Date <br /> DESTINATION <br /> Site Name S.F.I. Vasco Rd. Landfill P.O.# 02-100x5 Phone No FT 0 <br /> Address 4001 North Vasco Road, Livermore, CA 94550 <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 /> C <br /> Name of Authonzed Agent Signature ReceE ate <br /> PASS CODE <br /> SF1260.720 <br /> TRANSPORTER RETAIN <br />
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