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�. <br /> NO. 711182 <br /> 2 <br /> NON-HAZARDOUS WASTE DATA FORM <br /> 237649 <br /> Generator's Name and Maliing Address Generator's Site Address(ff different than mailing address) <br /> 7•"Irb.EVL-N, INC. 7-ELEVC:N 2iit'1:3'2 <br /> 1-1.0. [lox OCY1 11 41327 DA VINCI DPI VE <br /> RANCHO SANTA MARGARITA, CA 9268B MYOCKTON, CA @6207 <br /> Generator's Phone: W, <br /> Container type removed from site: Container type transported to receiving facility: <br /> Q<Drums ❑ Vacuum T rvok ❑ Roll-off Truck ❑ Dump Truck ❑ Drums X,, J! Vacuum Truck ❑ Roll-off Truok ❑ Dump Truok <br /> ❑ Other ❑ Other <br /> O Quantity Quanilty Volume <br /> ti <br /> r <br /> WASTE DEBCRIPTION (iJAI'Ir:Fa' GENERATING PROCESS 1RR"-'I J��il1�C•S(11t(�1hf=�t`.>"1fr11r�lt\t'��t�2 <br /> W COMPONENTS OF WASTE PPM 96 COMPONENTS OF WASTE PPM % <br /> I <br /> 2. TF111 =:1 LYr a. <br /> Waste Profile PROPERTIES: pH ,��(� ❑ SOLID LIQUID Lk SLUDGE ❑ SLURRY ❑ OTHER <br /> HANDLING INSTRUCTIONS: <br /> Generator Printed/rypedName Signature Month Day ,Year <br /> The Generator certifies that thwhaste as desortbed 11,'111L non-hazardoua �✓ <br /> Transporter 1 Company Name Phone# t <br /> transporter 1 Prfntedf pedName Signature Month Day ! Year <br /> 1 � : <br /> CC I ' <br /> 0- Tr n er Ackn vAed m nt f t t t o s I <br /> (n Transporter 2 Cg pany Name Phona# <br /> i <br /> NIrTO &SUNS TRUCKING, INC. T��i"I1;Ifl fi �it� <br /> Transporter 2 Printed/lyped Name Signature f Month Day Year I <br /> er{s erAo av:rladgmentef a (pto•Malerlale - , <br /> Dealgnated Facility Name and Site Address Phone# j <br /> DEMENNO1'EC::Il{:}t:I(?N 'i[I,v 7.7'it?t1 <br /> U 2000 N.ALAME:DA 9r. <br /> L CtJMPTON, CA 00222 ` <br /> 0 ' <br /> Z <br /> LLJ Pdnted/TYped Name Signature Month Day ear <br /> W 11 A 1144CC ' <br /> lyawataTFIR1111,O o -peretor by <br />