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Generator Information <br /> Name: ADVANCED GEO <br /> Address: VARIOUS SITES <br /> Description of water: Non-Haz purge water UST Sites <br /> Non-Hazardous waste water,monitoring well purge water and/or auger rinsatc,tank rinsate or above described water 7h is wat,r ma, <br /> contain dissolved hydrocarbons 1 certify that the above named material is a liquid exempt from rera per 40 clT261.4(b)(10) ind doe, <br /> not meet the cnteria of hazardous waste as described in 22 cer article I I or any other applicable state law.Has been property <br /> described Classified and packaged and is in proper condition for transportation according to applicable regulations. <br /> Venerator/Authorized agent >�� Lz~�� ��/`' �j ^( (� Gj <br /> Print sign t date <br /> i'ransporter Information: <br /> Company name: American Valley Waste Oil <br /> Truck Id Driver -� -c <br /> Print 7 sign ate <br /> Total Gallons <br /> Faciliry Information <br /> Cascade General Inc Approval Number 900-611 <br /> 5555 N. Channel <br /> Portland, OR 97217 <br /> ORD18761934 <br /> Via Railcar 9 <br /> Received by: <br /> Print full name and sign date <br />