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' NON-HAZARDOUS WASTE DATA FORM • <br /> GENERATOR: <br /> NAME Ryder Truck Rental, Inc. Properties and Construction Division <br /> ADDRESS 3600 Northwest 2nd Avenue PHONE: 415-820-9391 <br /> CITY STATE Zip Miami, FL 33166 <br /> ' 1 VOLUME Approx. 12 yds WEIGHTAPProx. 21 t n <br /> CONTAINERS_ <br /> TYPE: [ ] TA __NK [g] END DUMP I JOTHER <br /> ' WASTE DESCRIPTION <br /> Soil w/waste oil <br /> GENERATING PROCESS <br /> Tank removal & over excavation PPM <br /> COMPONENTS OF WASTE <br /> ' N/A <br /> PH [ g] SOLID [ j LIQUID [ ] SLUDGE <br /> [ ] OTHER <br /> ' HANDLING INSTRUCTIONS <br /> Wear gloves when handling <br /> Generator Certifies that the Waste as Described Is 100% Non-Hazardous. <br /> TRANSPORTER J <br /> NAME A.S.T. <br /> ADDRESS 3472 Enterprise pIONE; 366 <br /> CITY STATE ZIP Hayward, CA 94545 2173 <br /> SERVICE/P.O. NUMBER <br /> DRIVER'S NAME&SIGNATURE <br /> TSD FACILITY <br /> NAME Liquid Waste Management <br /> ' ADDRESS 565-33 Highway 58 <br /> NE: 1-80 5-7 62-7 3 6 6 <br /> CITY STATE ZIP McKittrick CA <br /> pFIO <br /> DISPOSAL METHOD <br /> ' TONNAGE RECEIVED> <br /> Printed Name SI nature Date: <br /> -:3' <br /> _ -:2- <br /> GENERATOR <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 SAMPLES <br /> ACCORDANCEON CHANGES AND THAT WITH FEDERAL AND STATEYPRACTICS. TAKEN IN <br /> ' GENERATOR SIGNATURE: �� ��� tZe���. DATE: <br /> S-tE , `Dell��e c R.y / <br />