Laserfiche WebLink
' LIQUID WASTE MANAGEMENT, INIO 42485 <br /> ' STAR RTE. BOX 4, CORNER HWY. 33 AND HWY. 58 <br /> MCKITTRICK,CA 93251 Approval# <br /> (805) 762-7366 <br /> 3-209/ 7/ <br /> Scale Ticket # <br /> ' Lease <br /> Well#-7 , <br /> Ph# G <br /> Approved Disposal Site Operator <br /> McKITTRICK LIQUID WASTE MANAGEMENT, INC. <br /> ' LIQUID WASTE DISCHARGE REPORT <br /> A, Liquid Waste Source: <br /> Company <br /> Add\ress�, <br /> ' Description: soil ❑ Brine ❑ Drilling Mud ❑ Other. <br /> ' B. Licensed Waste Hauler 7 <br /> Company 7/ TtiL 1 Z <br /> Address'. (�Truck 0 _D e - <br /> C. Delivery Date: �y G D. Invoice* Hauler <br /> Date:� -,2n / Waste Source <br /> Quantity <br /> —T Wash Out @ $ ea. <br /> Cost Per TonTotal Cost. . . <br /> ' 'I.certify that the above d ibed waste was hauled to this approved dispos ite and wa nble <br /> waste as est hed y Or r No. 72-256 of the California Regional W e ualiry oar <br /> i <br /> ' Signature of Disposal Site Operator HAULER S' nat a of Licensed Hauler <br />