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NO. 6601973 <br /> ' NON-HAZARDOUS WASTE DATA FORM <br /> ;. EPA £':.iii^`�r'S NOR <br /> y,¢' <br /> _ } <br /> LD <br /> NAME LISA PETROLEUM CORPORATION iR <br /> � <br /> 3191 AC-OURk COURT 4200 4 k" <br /> ADDRESS AGOURA HILLS <br /> CITY STATE ZIPS 41301 PHONE NO ( 1 <br /> CONTAINERS:w VOLUME wEIDNr <br /> TYPE: ❑ TRUCK ❑ TRUUCK❑ oRUMs G cARTONs ❑ OTNEA <br /> z y��T <br /> wArE <br /> sDFsaaPno <br /> pON-HAZARDOUS WATER OENERATINOPRODE SLL �UP•GIY�4/D€CGIY'WATER <br /> COMPONEM90FlYASTE PPM M <br /> COMPONENTS OF WASTE PPM Ga <br /> •.,�ti.; , WATER49-10470 <br /> 2 TPM <br /> a BESIR � � J <br /> s r <br /> 3 <br /> p 9 <br /> �'.T. -1y <br /> -PW ❑ SOLD ❑ LIQUID ❑ swU. E ❑ SLURRY ❑ OTHER <br /> PROPERTIB: <br /> HANDLING INSTRUCTIONS: <br /> LAPPROPR .5 OT GIVE CLOTHING <br /> THE GENERATOR CEHTIFlES THAT THE f f L//s�5 <br /> '.il WASTE AS DESCRIBED IS 100% ��(/_ fII' <br /> NOAINAZARD0U9„ �.�� 'A ESI&S r BP <br /> I' <br /> DATE i J ii' f ✓ � TYPED OR PRINTED FULL NAAIEA SIGNATURE - � <br /> Tr3asputter *1 Transpi6lilm, P <br /> 6 NAME <br /> Sl-fAi'US ENVIRONMENTAL [/. L� - No -_: <br /> „�,� <br /> ADDRESS 3330 CAMER13N PARK D(It JE CvS 530 .�/✓T.n}.3()51 d;l.i ti 'GERD <br /> RVICE ORDER NO <br /> �QQ i <br /> ary STATE zld'''MK""`'11P! PAS6{CA 336M Rfu(C/ Ps/.C,10 PICK uPDATE <br /> ter. / �.•" �I <: Po=T L. <br /> PHONE <br /> 'b¢:y �7 E PRINTED FULL NAM LSIGNATURE DATE <br /> TRUCK.UNIT I.D.Y0. <br /> EPA LS?:�.•P...• s�� <br /> - c^ D xs6Y.>;. A•—'R .:r 'xea-T^t'>LT <br /> NAME SEAPOR3'FEjgpjMG & E6VLRROi AEKTAi. LLC No ' a-+ "+� �E? -• _ <br /> y OL9POSAL METHOD <br /> "V )40 SEAPORT BLVD. ❑ IANORLL LJ OTHER <br /> :L ADOIIE99 <br /> y�.i:,,• P.::L�`�1r'VO'J Ll�'T. r: <br /> =("'L'•' CRY STATE 9P <br /> PHONE NO <br /> �A� vl.i1 Ofl NTEO FULL�IIAAEt3gNAT� URE DATE <br /> y,s` pEN OL IEw L A Tons <br /> �` TRANS 8 8 <br /> RTAS HMF <br /> = NONE DISCREPANCY <br /> r <br />