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t WHAZARDOUS WASTE DATA FORM • <br /> ' GENERATOR: <br /> NAME Ryder Truck Rental, Inc. Properties and Construction Division <br /> ' ADDRESS 3600 Northwest 2nd Avenue <br /> CITYSTATE,ZIP Miami, FL 33166 PHONE: 415-820-9391 <br /> ' CONTAINERS 1 VOLUME Approx. 12 yds WEIGHTApprox. 21 tun <br /> TYPE: [ I TANK [x] END DUMP I LOTHER <br /> ' WASTE DESCRIPTION <br /> Soil w/waste oil <br /> GENERATING PROCESS <br /> Tank removal & over excavation <br /> COMPONENTS OF WASTE PPM <br /> N/A <br /> 42 <br /> ' pH [ x] SOLID [ ) LIQUID [ J SLUDGE <br /> [ IOTHER <br /> HANDLING INSTRUCTIONS <br /> Wear gloves when handling <br /> Generator Certifies that the Waste as Described is 100% Non-Hazardous. <br /> ' TRANSPORTER <br /> NAME A.S.T. <br /> ADDRESS 3472 Enter rise t{!� �3 (6??3 <br /> CITY STATE ZIP Hayward2 CA 94545 PHONE:14.,,,. 7L6�6 <br /> ' SERVICE/P.O. NUMBER 2173 <br /> DRIVER'S NAME &SIGNATURE <br /> ' TSD FACILITY <br /> NAME Liquid Waste Management <br /> ADDRESS 565-33 Highway 58 <br /> CITY STATE ZIP McKittrick CA PHONE: 1-805-762-7366 <br /> DISPOSAL METHOD <br /> TONNAGE RECEIVED> <br /> 7rinted Name Signature, Date: <br /> GENERATOR HEREBY CERTIFIES THAT THE ABOVE INFORMATION IS TRUE <br /> 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. <br /> � <br /> RE: DATE: <br /> qNENERA <br /> ' � O 0 SIGN SIGNIA�i \ <br />