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a�s[ur► a►H1H �Hhhd <br /> ��1111L1\:Jl:.11J ����O� C��UUU D a p <br /> ° aid EgUOPMSM C (DFp0rrC�$`o� CE <br /> gig: <br /> P 0 RDx 507 Q VACAVILLE, CA 95696-05071 <br /> FACILITY NAME: � 1 ( t' 1 ? ` 1' or <br /> ADDRESS: = - t c <br /> NUMBER OF DRUMS ON SITE: CONSULTANT <br /> ARE DRUMS LABELED? YES NO TYPE OF LABEL <br /> GAL. GAL. GAL. GAL. LEFT <br /> DRUM TYPE H GAS. REMOVED ON S I TIE COMMENTS: <br /> 2 <br /> �- I <br /> 3 c C <br /> 4 <br /> 5 <br /> 7 cp <�' c <br /> 8 � � C <br /> 10 C;S <br /> 12 <br /> LIST BELOW THE DRUMS THAT WERE NOT EMPTIED <br /> LABELING GALLONAGE REASON FOR NOT <br /> DRUM TYPE IF ARTY CONTENT LEFT IN DRUM EMPTYING DRUM <br /> 1 <br /> 2 <br /> 3 f <br /> 4 <br /> 5 <br /> 6 <br /> 8 <br /> TOTAL GAL. REMOVED: EMPTY BARRELS LEFT ON SITE: <br /> BARRELS REMOVED: TOTAL - -©F BARRELS REMAINING ON SITE: <br /> FIELD TECHICIAN: DATE: <br /> r <br /> REV. 6/91 CONTRACTORS LICENSE NUMBER 498721 <br /> VACAVILLE (707) 437 6668 SACRAMENTO 1916) 4412886 FAX 1707} 437-4357 <br />