Laserfiche WebLink
a— 1', 1001 gs 5--. 4@91 %11- :�35 INC F-1nE 0� <br /> N s o O 5 n <br /> NON-HAZARDOUS WASTE DATA FORM <br /> EPA <br /> NAME �:E C O 11 "i g i1 1 i „ .—. µa I !`!I <br /> ADDRESSC}U1 jarrar_SC)n _fit � Room 112/ <br /> CITY STATE,zips H a u s it 0 n <br /> PHONE lE NQ ( `�l i Z V 6-J"� <br /> +�cnrssal7Ee -7- <br /> W—ELG IT OR VOLUME UNITS <br /> Lu <br /> W � <br /> i� <br /> CONTAtNEA9 �'"' TYPE OTANK TRUCK l�dbaurns ❑DUMP TRUCK❑CARTONS �nrt�ER <br /> mWASTE DESCRIPTIO N� e t 3 g t' �' j 1 ,1 1g;j 8 z -- pENQRaTiN4 PAOCE9� <br /> COMPONENTS CF WASTE PPM % CQMPONI i41 OF WASTE PPM-:tv pure�e <br /> D <br /> Water 99--100 <br /> fetroleum rijydrocarpoas tJ e <br /> 0 <br /> tu <br /> O ; 8. <br /> N <br /> PROPERTIES nM 7-Y ❑301-0 KI LIQUID ❑ sI.JPGE ❑ SLURRY ❑ CT"ER <br /> 4iANDLINE3 INSTUCT10N8 Wear A Aro z 3 a t e r tirmt11 T1 t <br /> QENEFIATOR CER71FJCATION Thi:Is to carVfy tlTElt tMe almye named waste matNtals;rs 10011 non-1laiardous Eno ars nat reoutated accord <br /> Ind to �Itlter 60 CPR 1USEPA3 or 80011csiaia State riyulattcns In aapltpon the above narn■d wasts matarlals are property 6atcrloea, pacx;asd <br /> Rt rxtomu Naeleo sno are in proper conaitIan fQr trenavortatEVn arcurwmA tw 411 ippIIumw*reputations <br /> Consult;att for Exxon P oDjl <br /> TYPED OR PRI NTID FULL NAME d 3iGNATURE BATE <br /> EPA <br /> NAME Service 5tation Systems, Inc. N '.C I_A� R, 0r 0 1 Q 10 i� <br /> W .,. _._ - <br /> 1236 N. Fifth Street <br /> 9l:AVICE❑iiol:ri nc <br /> iCITY STATE ZIP- .San Jose, CA 9511 PICK UP DATE <br /> dc <br /> PHONE No 408 971-2445 <br /> TRUCK UNIT 1 0 NO MPEO OR PRINTED FULL NAME b SIGNATURE i0l �j <br /> EPA <br /> NAME C r a s b v And U V e r"t Q r3 inc , No S 17 E 1 - --86--1� ={- <br /> 01SP03AL 1AET11013 <br /> ,00c+[aa t h ill W 1 7 t h treet a LANDFILL. ❑ 0Tu6a <br /> J <br /> Qc1Tr $ral r. zsP 3-o h n -_t5-&3 C <br /> PHONE Na 4,34-7445 <br /> QUANTITY _- __ TYPED OR PRINTED FULL NAME&SIGNATURE :ATE <br /> pl SC R EPiiNL-Y <br /> c <br /> 0 rORM NO 0 1-7 41 4153 WHITE-ORiGINAL CANARY-TO TRANSPORTATION PINK TO GENERATOR GOLD-3ENERATOR <br />