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NON -HAZARDOUS WASTE DATA FORM <br />56526 <br />Msrftis� M: <br />RECEIVING SITE SENDS TO GENERATOR <br />i' <br />SHE'LL F~!l9I UNEC COWS LIP M SO�IURA �EHt# T.Sr-1 A <br />NAME <br />ADDRESS <br />HOUSTON, 771252- � <br />CITY, STATE, ZIP 'PHONE NO. ( 711),_741-5036 <br />Q <br />0 <br />CONTAINERS: No. �; VOLUME WEIGHT { POLM&k <br />_ _ <br />4 <br />LLI <br />Z <br />TANK DUMP <br />TYPE: ❑ TRUCK ❑ TRUCK a DRUMS ❑ CARTONS ❑ OTHER <br />W <br />C5 <br />WASTE DESCRIPTION ]-)EBP.18 WrGMS011NIF GENERATING PROCESS <br />>_ <br />COMPONENTS OF WASTE PPM % COMPONENTS OF WASTE PPM % <br />W <br />I. s. <br />H <br />LJ.I <br />711E ROTR <br />aISPOSAL, CED L�'A WAS <br />J <br />2. YFu `4 S 0 OR REZJSE`�`TVFT) W. <br />F' CRpSBv AND <br />d <br />2 <br />TO ST <br />(E me yipON T��M, a TRE D„ a Oti"LRTON. !NC ppm �R a ESE({rE <br />RFsol1RCE mz'TAL PRp NARTk!r:"r "'4C O ERATFS Yl 0�'Sm <br />I OF TO 17LE FA(: <br />3. ANp17i ATTON+bt� <br />ACCp1976 <br />W <br />h'LR'N S To TE RE 'C:LY pi' 711P Pt NCANDrn 0SB Y& 4 OF <br />4� ��DLVN7N APpQ�O <br />4 8�' .. l I <br />No '..'...' <br />m <br />WAS' HAS gam, � SAR <br />Q <br />PROPERTIES: pH EJSOLID ClLIOUID ElSLUDGE E)SLURRY 13 OTHER SOLID IDLED <br />} <br />HANDLING INSTRUCTIONS: `�`I HOLR E _4GE f P"OM INIUMBER (&W) 424 <br />35 f 5 tFii[m' <br />pTOCKTON CA 95201 TYPED OR PRINTED FULL NAME & SIGNATURE , DAT, <br />T3 4`f a a1iV TTiilC'Ys13JCi <br />IY <br />NAME <br />W <br />© <br />1040';UhMT ROND <br />ADDRESS SERVICE ORDER NO. <br />CL <br />ZCITY, <br />wAT'� 7[�'V'� AX_ CA 9'507a -, <br />STATE, ZIP PICK UPDATE <br />Q <br />( 409) 211,)-4666 <br />PHONE NO.�' , <br />,�" �� r <br />7 144 <br />TRUCK, UNIT, I.D. NO, TYPED OR PRINTED FULL NAME & SIGNATURE DATE <br />CRCISRY AND INC, <br />NAME 1 ��}�, r l� �� <br />} <br />IeO W. 17TH 31'111:'£='9` 11 DISPOSAL METHOD <br />} <br />ADDRESS E:JLANDFILL ❑ OTHER <br />J <br />(� <br />Lo Nkl BEAM C.,A. 9M3 <br />CITY, STATE, ZIP <br />LL <br />PHONE NO. ( 2) 432-544 <br />IA <br />� C .� N-, 7� .. _-,'f'0`�'Y �.�;,.'�" .�.,^ �9.1T'.r +G� .r•�,{�r' ' ; - � i, <br />I� <br />W TYPED OR PRINTED FULL NAME & SIGNATU E ' ` f DATE <br />A TONS <br />GEN OLDINEWLFtTIOD <br />TRANS B <br />CIO HWDF NONE DISCREPANCY <br />Msrftis� M: <br />RECEIVING SITE SENDS TO GENERATOR <br />i' <br />