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DATE: <br />FROM: <br />1.) Site: <br />SHIPPING PAPER -GOMES (INSTRAT) <br />Pacific Gas and Electric SIGNATURE <br />McDonald Island <br />Nearest Town: Holt, CA <br />County: San Joaquin <br />Specification 956/ <br />Attachment 1 Page AM <br />PG&E PERSONNEL <br />PG&E Division: ED Gas Trans M&C <br />Quantity (Barrels) bbls <br />Time of Pick-up: <br />Quantity (Barrels) <br />Time of Pick-up: <br />2.) Facility: Well Water Management <br />Sanchez Farms 1-15 Quantity (Barrels): <br />Nearest Town: Rio Vista Time of Pick-up: <br />County: Solano <br />Alternate Facility: Quantity (Barrels): <br />Nearest town: Time of Pick-up: <br />County: <br />Signature of Receiving Agent <br />COMMENTS: <br />TRANSPORTER: <br />Name: WARREN E. GOMES EXCAVATING <br />Address: P.O. Box 369 <br />Rio Vista, CA 94751 <br />Phone No. (707) 374-2881 <br />Cell Phone (916) 768-0269 Charlie <br />EPA I.D. CAD076557370 <br />Vehicle No: <br />Haz. Mtls. Transp. Lic. No: 3321 <br />Drivers Name: <br />Signature: <br />CONTACTED BY PG&E EMPLOYEE (Name) Rosie Montez <br />Date Time: Phone No. (209) 944-1413/1411 <br />Special Instructions: MUST HAVE SEPARATE TAGS FOR INSTRAT (D-3 & D-4 TANKS <br />Vessel: <br />Location: #BBLS <br />Vessel: <br />Location: #BBLS <br />C5 & 6 <br />WSS <br />C5 & C6 <br />TCS <br />C30 <br />WSS <br />C30 <br />TCS <br />D3 /D4 <br />WSS <br />D3 /D4 <br />TCS <br />DI -A <br />MCS <br />D303/304 <br />MCS <br />HM Ouantity (Barrels) <br />X Gasoline (natural), flammable Liquid, UN 1203 <br />Natural Gas Production Fluid <br />........BBLS Primarily a non -hazardous aqueous brine solution <br />produced from natural gas wells. Fluid May <br />contain an organic phase consisting of natural <br />gasoline and other organics <br />Certification required by 49CFR172.204 (a) "this is to certify that the above -name material are properly classified, described, <br />packaged, marked and labeled, and are in proper condition for transportation according to the applicable regulation of the Department <br />of Transportation." <br />