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Ws -T-- <br /> ',.` "�. ti•• s �- ai.m --- eras ,+y ti: i.•' -��i <br /> r <br /> vcr �cry. r4ruo LIQUID WASTE MCT INC (805) 762-7696 <br /> rnun Cnl,un nim,, P,GO 1 <br /> LIQUID WASTE nu,l� r s <br /> .rt 4 P;Y••d'14$•'•.tl.Ser ':Sat•4S•'d•'.r'•L44•::4UPrA•, <br /> -MANAGEMENT,INC, zapprov�i na.&r <br /> ORNERATOR,o WABTE PROFILE <br /> A. GENERAL 114FORMATION <br /> Cenerafor name Transporter moms � P L7 <br /> Address: (�� !a Ee Address is <br /> --------------- <br /> n) 72s6: <br /> Ttwhnloal OanlOefl . KC'i Technical eonioet: <br /> Phone: 6 ,,a- Chane: <br /> General aIle aaNvltys -UZ4-6��.s�rP� Slate hazardous wasfs <br /> Process generaling waster G Loular licenser t , '1L,o lgL <br /> Ars any hozardoue Or palentlally hazardous maforlais'stored or used on site? Yea No <br /> It Yea. plooss-Ifslr O <br /> Rill t0-,-.6A/4QjL, pe�dM <br /> d o — Attention• <br /> $ P-0./Job no.: <br /> P. CHARACTERISTICS OF THE WASTE v.r7 i <br /> LTsI any known sus paled 7-Kic .; <br /> / P egeedeus oomponsnfc t�t1.f �rl .}� rr:.::• �', tSL H��'s!,I <br /> Check all that apply (a InTnlmurn of ons per column <br /> CfartNr p <br /> U51 removal �p- Way O Cfw■I G Rlet}}Me Physical dears <br /> 17 TOlhsrt, _.� G �e �A!ire: 00 )R I✓A 0 Seciif-sof{d <br /> IoysnL_ pmt nagh PdntL <br /> A IquIda, A wlfde, <br /> G. ANALYTICAL (Cheek all that apply) <br /> 15 H ay,,�cal data otiaohed <br /> 0 ChC(n of ew" citoahod <br /> 0LAw <br /> 17 metals tl p,�an1G trod <br /> s <br /> rwU <br /> 0. SHIPPING INFORMATION - <br /> Anflelpoled volume: <br /> r 9ansie ��.OoAons - <br /> YON3 —7ona Glher�,,,ti <br /> � Baslef <br /> p <br /> r..... -">r One Vme 0 Wcvk G >/andA tl Quarter O Yaw Es4maled no. or trucksL_J�.�..� <br /> v E. GENERATOR'S CERTIFICATION& <br /> F h■rsOr C,9, that thl■ sampts la Gvly raprgenlothv art the obovltnynllanrd haat&. 1441w to natty Wm Y there it <br /> a ohan9e F vu yeneratln9 Praaw Mol would result 1n a ahanga In lh■ wade, I ossa a:ritwrlrr LWIS to W dtra <br /> C rwroh=e the rode, etn4y espenH, Irr t[,a Purpose or rseharoeieriza4Jan. I oerV[Y that all spm��ptee wan aofleated� <br /> poop& n FGA itellwd Sw.d4e and 'hat thea ra Aote Ohaln pf cL'■tod Is ottoohed. 1 <br /> t� suhfefil INe ono Oita dreueieelrt b PP P �r me that dG IhfbMwvca <br /> c:nuplete end r_sm�le an_tMst_o_ff-_known/ er_suspected-hatoMs Mw- - — -- -- ------- ------— <br /> PROM <br /> ..Cr Y .{I�f .R Y t0 }: :•r.. ;.s•. %. :Ys r.!t+t��Ttanr�•;:t.}r <br /> tib;• tr <br /> FACILITY OPC13i0N,:.•'. .,��..,.. iiii;5i,•s�,=:i:•::i�Si�si� tr <br /> 0 Aoaspt , 0 Reed a momRILLINO INFORMATION <br /> a s ti r ❑ Accept 0 R•joct M <br /> LWW account no,t <br /> Comments <br />