Laserfiche WebLink
-" LIQUID WASTE MANAGEMENT, INc. 42484 <br /> ' f STAR RTE. BOX 4, CORNER HWY. 33 AND HWY, 58 <br /> MCKITTRICK, CA 93251 <br /> (805) 762-7366 Approval # <br /> Lease Scale Ticket # <br /> Well# —7 <br /> ' Ph# / / O <br /> Approved Disposal Site Operator <br /> ' McKITTRICK LIQUID WASTE MANAGEMENT, INC. <br /> LIQUID WASTE DISCHARGE REPORT <br /> A. Liquid Waste source: <br /> ' Company �� � <br /> Address <br /> Description: '-0 soil ❑ Brine ❑ Drilling Mud ❑ Other <br /> B. Licensed Waste Hauler <br /> Company / / - / / • / �-C� e <br /> ' Address <br /> Truck A — <br /> C. Delivery <br /> yDate: D. InvoHauler <br /> Date: h �( ^�/ Waste Source <br /> 1 Quantity r�� Tons Wash Out: @ $ ea. <br /> Cost Per Ton Total Cost <br /> -1 certify that the above described waste was hauled to this approved disposal site and was an acceptable <br /> _= stag bli;hed by e No. 7� 56 of the California Regional Water lity Control Board.' <br /> Signature of Disposal rite Operator HAULERignatur ' ensed Hauler <br />