Laserfiche WebLink
1 'PN-HAZARDOUS WASTE DATA FORM • <br /> 1 <br /> PERAT6R: <br /> 1 Ryder Truck Rental, Inc. Properties and Construction Division <br /> ESS 3600 Northwest 2nd Avenue PHONE: 415-820-9391 <br /> ,STATE,ZIP Miami, FL 33166 <br /> NTAINERS 1 VOLUME Approx. 12 yds WEIGHTAPprox. 21 t n <br /> TYPE: [ ] TANK [g] END DUMP OTHER <br /> 1 WASTE DESCRIPTION <br /> soil wGaaste oil <br /> 1 GENERATING PROCESS <br /> Tank removal & over excavation <br /> 0/0 <br /> COMPONENTS OF WASTE PPM <br /> N/A <br /> 1 Ca <br /> i <br /> 1 pH [ ] OTHER <br /> DGE <br /> [ ] LIQUID ( ) SLU <br /> 1 HANDLING INSTRUCTIONS <br /> Wear gloves when handling <br /> 1 Generator Certifies that the Waste as Described Is 100% Non-Hazardous. <br /> TRANSPORTER <br /> NAME A.S.T. <br /> ADDRESS 3472 Enterprise <br /> 1 PHONE:1 66 <br /> CITY STATE ZIP Hayward, CA 94545 <br /> SERVICE/P.O. NUMBER 2173 <br /> DRIVEII'S NAME &SIGNATURE <br /> 1 TSD FACILITY <br /> NAME Liquid Waste Management <br /> ADDRESS 565-33 Highway SS <br /> 1 CITY STATE ZIP McKittrick CA PHONE: 1-805-762-7366 <br /> DISPOSAL METHOD <br /> 1 TONNAGE RECEIVED> <br /> Printed Name SI nature, <br /> Date: �� <br /> 1 w11 . 7/ o _5-� T�/ <br /> GENERATOR HEREBY CERTIFIES THAT THE ABOVE INFORMATION IS TRUE <br /> 1 TO THE BEST OF HIS KNOWLEDGE AND AGREES TO NOTIFY A.S.E <br /> IF INFORMATION CHANGES AND THAT ANY SAMPLES WERE TAKEN IN <br /> ACCORDANCE WITH FEDERAL AND STATE PRACTICES. 5 r <br /> 1 GEN T TUBE:I lZy c�-c- kc Z2 �s DATE: <br /> 1 S <br />