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® ERICKSON "'' _ N0- 2 6 7 5 <br /> 255 Parr Boulevard,�:hmond,California 94801 <br /> (510)235-1393 • FAX (510) 235-3709 <br /> NON -HAZARDOUS WASTE DATA FORM <br /> NAME Santa Fe Railway - EPA <br /> LD. C A D 9 8 1 4 5 9 9 4 4 <br /> ADDRESS <br /> P 0 Box 1947 NO <br /> CITY.STATE,ZIP Fresno, CA 93718 PHONENO. (209 ) 441 -2564 <br /> CONTAINERS: No. 1 VOLUME < 1 cubic yard WEIGHT <br /> O <br /> II- <br /> 4 TANK DUMP <br /> ¢ TYPE: ❑ TRUCK ❑ TRUCK ❑ DRUMS ❑ CARTONS ❑OTIicR Dla-,t-c w-ap <br /> Lu <br /> Z <br /> W WASTE DESCRIPTION Transite sheets GENERATING PROCESS Construction remodeling <br /> LU <br /> Y COMPONENTS OF WASTE PPM % COMPONENTS OF WASTE PPM % <br /> m <br /> LU , Nonfriable asbestos transite sheet 100% 5. <br /> I&A <br /> J <br /> d 2 6. <br /> O <br /> U 3 7, <br /> W <br /> 0 6. <br /> O <br /> H <br /> PROPERTIES: OH N/A ® SOLID ❑ LIQUID ❑ SLUDGE ❑ SLURRY ❑OTHER <br /> HANDLING INSTRUCTIONS Handle in a manner not to damage the double wrap plastic <br /> THE GENERATOR CERTIFIES THAT <br /> NTHE ON-HAZTEAS ARDOUS. <br /> 15100% J Q� /r <br /> NON-HAZARDOUS. l_�Q �S <br /> TYPED OR PRINTED FULL NAME 6 SIGNATURE DATE <br /> EPA <br /> LD. D 10 10 19 14 16 16 13 9 12 <br /> W NAME Erickson, Inc. No <br /> OADDRESS 255 Parr Blvd. SERVICE ORDER NO. <br /> Ill. Richmond CA 94801 �—� q Gl <br /> ZCITY,STATE.ZIP PICK UPDATE <br /> ¢ PHONE NO. 1510 1235-1393 <br /> b&1,\) /�) \ f <br /> TRUCK. UNIT, I . NO. J -7 TYPED OR PRINTEDFULL NAME&SIGNATUR DATE <br /> / EPA / VVV <br /> I.D. <br /> NAME B & J Landfi 11 NO. <br /> ,//� 11Y DISPOSALMETHOD <br /> >. ADDRESS �� F-b / 11 M <br /> 01 ANDFILL ❑OTHER <br /> � CC A <br /> J CITY.STATE.ZIP Ad--15 15 V t � � 1. 41 / <br /> 1707 1451-3276 <br /> LL <br /> PHONE NO. <br /> 0 1 <br /> (n TYPED OR PRINTEb FULL NAME 6 SIGNATUR D E <br /> f <br /> GEN OLD/NEW LA TONS <br /> TRANS S B <br /> C'O RT/CD HWDF NONE DISCREPANCY <br /> CP6067 <br />