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eahr,/1998 21:48 209831, 'JS CITY OF' TRACY PAGE 02 <br /> 't} lkt�,l'1':]`�T„ 1�I:kl`,. J.{_11y�33'25�`'�G l+l>-1?ti>•-tT EhiV1'•'t N�Ri�1,��:1L. � t, t� .. <br /> 08/:8/t1,K ftU 10, LZ rAA `Vr Sop I,uo• +•.�• �.... <br /> >�tOn�a S3976 <br /> FORWARD <br /> INCORPORATED APPROVAL 41 <br /> WASTE PROFILE FORM <br /> l�.r,A$&VFTACH liT AA;D Ro M' FORWARD&C.. P.0. Box 63j&SrocrroN. CA 9j�W FA1C(ZOO)466.1067 PNt7N!(209)466-II82 <br /> A, GRMERAL INFORMATION i <br /> � r <br /> �� Q� /b C ,.., s.� <br /> Ce <br /> aAemor N+1ltu: r <br /> Billing Addlsra• <br /> M>w&I Ad4less: <br /> : 9tstt:C 7.i : Cit!': <br /> City <br /> Title: JO, corom <br /> itk- r.gjakidalz <br /> Contact: ,�/ Ttticplt4Qt �•Q�" >uc Na.: s!' x.31"1. <br /> IblsphoneNa.:,�-g,f; YYS!LOO_-- -FuNo.: : <br /> Canlulgatt Narnr, jt �� �I .A a 5iev-,W Tmoporter: <br /> Mallin Addrsar 'f+ Meiling Addlaas:. Z <br /> City: 8 State: ,Zip:�, city. jQ <br /> 8utc:r Zip:. y1►�. <br /> y Tide; Cvntart 1�Uo:� <br /> can4cTT <br /> 1Y-t D7TQy7 . <br /> Telephone No.: - u No.: - <br /> 3.WAST'Y.STREAM J))9V nCAT1QN <br /> d V r� G � C,TOfdt;;�+ Propvf Y <br /> Site Addiear: �p <br /> pesatil►tloa of waste: • <br /> ?races gcsttrstu,g.�rat+te: <br /> C. WASTE MUM Diss mom <br /> 1. Waste Type: yoit d�sludge Q Ash O Tfaated wood O Debris 0 Aebestas O 0Uw <br /> Z. Anticipated volume: t,�ron tTCubia Yards j O Drams- 0Othe: <br /> 3. Method of Shipment: uik wlid neomuncri (Tr�Ml: <br /> A. Shipping Prtquency: Q Monthly O Yearly WO'noTlrm O Other -- - <br /> 5. Akb,stos Contairtm Method: 0 Hags 0 Cement+ ❑1'1mrm t]Wrapped 0 Other f►. DOT Proper Shippin Nsmc <br /> 7. t'hypiGal State: O Sim" 0 Pasta O Powder O Goo a. Percent Moistt�re:.� - <br /> 9. Odor. Q 5wa= itd O Nave 10. Calor of Material: 11. pH:__ <br /> 12. Soil Typc. qa� 1 .Satttd ,•,Gp gilt _ a -Gley 13. Pito Standing Liq�i4-- O Yes,ro f <br /> 1). ANA LY'nCAL gVMMANY(ATTACU ALL CER'"TMD ILAD RUULTs AKD Cwtr Or CUSTODT 0000MWTAr0N) 3rr moi//aerlCf/ <br /> TOTAL PETROLEUM AVG �IIG� Unita wmx(EPA MO) AVG MGH w" <br /> HYD1tOCARBaI~19- �Pb b) ' <br /> vOLATM's ORGANICS SFMI•ygLA'�I.B <br /> i,ist Dbtaded Xnalvitii <br /> tical Math 1 Mstlseds <br /> f <br /> E <br />