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i <br /> FORWARD <br /> PROFILE# 9594 <br /> `►� INCORPORATED APPROVAL# <br /> i WASTE PROFILE FORM <br /> PLEASE DETACH AND RETURN fo FORWARD INC P O Box 6336, STOCATON, CA 95206 FAA (209)466-1067 PHOA'E(209)466-4482 <br /> �k GENERAL INI ORMATION <br /> Generator Name Uwor_AL_ Billing Name SEs± �-Ta2 04EP <br /> Mailing Address 2=0 r-RDvJ cA�aIrbrJ PO-.ACP- 5 01= 14-0-Q Billing Address <br /> City SAIQ P__�X3 State CA Zip_9/4583 City State Zip <br /> Contact rpt 5-MQ Title4Avmi Q 6i=oLb66-C Contact Title <br /> Telephone No (5io)277-Z31 t Fax Na (5,clz-rr Z30q Telephone No Fax No <br /> Consultant Name Ci Fi C IWC Transporter Ma..ar ey d 5oxa5 -rkuCKcrjG, t),JC <br /> Mailing Address 2025 GA A FACE u D Mailing Address 96 FJ-1,ER- cfiE�1C RaAE <br /> City N _W5E7State cA Zip 9,110 City SA r_P_- .r stF State Zip_.,45528 <br /> Contact -nm R i Title 52 STAVE C-EXC615-7- Contact -n ).JL-FTitle ow�JFZ <br /> Telephone No 406- 41-11-75CDD Fax No N0'8- 41 41-7531 Telephone No c7i6-381- Fax No q16-391-1573 <br /> B WASTE STREAM IDENTIFICATION <br /> Site Address FoRMM uAocAL5siN"E Brtt_ioxl D12-3 +03+{cr..kj l-ANF-WUF. Ar 11711 5�7` -rFeAC_,e,eAJ_ii~ci3if, <br /> Desenption of waste 5oiL- IHPAc-riZt, 1BY_PF--P 1J 1 wY 0CA;;t -- <br /> Process generating waste ExcWA-noiJ OF uu> C A C Sou>�� 5-rarrAGE -rau�5 <br /> C WASTE STREAM DESCRIPTION <br /> 1 Waste Type 1KSoil El Sludge CJ Ash ❑Treated Wood �]Debris ❑Asbestos ❑Other <br /> 2 Anticipated Volume U Tons ')I Cubic Yards `75 ❑Drums ❑Other <br /> 3 Method of Shipment XBulk solid ❑Containerized (Type) <br /> 4 Shipping Frequency ❑Monthly D Yearly One Time ❑Other <br /> 5 Asbestos Containment Method ❑Bags U Cartons ❑Drums D Wrapped ❑Other uA 6 DOT Proper Shipping Name SOIL <br /> 7 Physical State ,Solid ❑Slurry Ci Paste ❑Powder ❑Other 8 Percent Moisture Q/A <br /> 9 Odor ❑Strong %Mild ❑None 10. Color of Matenal 81it>+ujAl TO Crr.E tS[4 G��' _ 11 pH M1A. <br /> 12 Soil Type % 20 Sand 4(0 Slit 4(0 Clay 13 Free Standing Liquids ❑Yes allo <br /> D ANALYTICAL SUMMARY (ATTACH ALL CERTIFIED LAB RESULTS AND CHAIN OF CUSTODY DOCUMENTATION) <br /> TOTAL PETROLEUM AVG HIGH Units BTEX(EPA 8020) AVG HIGH Units <br /> HYDROCARBONS (PPM (PPM <br /> (Specify Method-e g.8015) / b) / b) <br /> Gasoline 2Zo 27o P!-M Benzene 0 25 25 ?PM <br /> Diesel Toluene 0 A40 0 1H0 ASM <br /> Motor Oil or TOG Ethvibenzene 1 0 1 0 PPM <br /> Other Xylenes 2R 29 PPM <br /> VOLATILE ORGANICS SEMI-VOLATILE <br /> (Specify Method-e.g 8260) ORGANICS(EPA 8270) <br /> List Detected Analytes- List Detected Analytes: <br /> Other Analytical Methods Other Analytical Methods. <br /> 23 PPM <br />