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Jun- 25-00 23 !�02 SQbPorrt PQtro l mum 6SO 364:L&' 11 `.: P . 02 <br /> r� <br /> Seaport Environmental <br /> 111111mor R_ <br /> -, <br /> NON—HAZARDOUS WATER TRANSPORT FORM <br /> E GENERATOR INFORMATION CUSTOMER INFORMATION <br /> II. Coati Group- Penny Newman Gain2 3 JAN NOR CAL OIL INC <br /> 1805 Harbor St RECE'llE� J� <br /> ` Stockton Ca PO V <br /> DESCRIPTION OF WATER: Mnnitorin9 well development <br /> NON-HAZARDUUS WASTE WATER,MONITORING WELL PURGE WATER AND10R AUGER KINSATE.TANK RINSATE OR ABOVE <br /> DESCRIBED WATER.THIS WATER MAY CONTAIN 0ISSOLVEDRYDROCALPRONS.I CERTIFY THAT THE ABOVE NAMED MATERIAL <br /> IS A LIQUID EXEMPT FROM RCRA PER 40 CFR 251.4(b)(10)AND DOES NOT MEET THE CR17ERIA OF HAZARDOUS WASTE AS <br /> DESCRIBED IN 22 CCR ARTICLE•i t OR ANY OTHER APPLICABLE STATE LAW,WAS BEEN PROPERLY DESCRIBED. <br /> CLASSIFIED AND PACKAGEI)AND IS IN PROPER CONDITION FOR TRANSPORTATION ACCORDING TO APPLICABLE <br /> REGULATIONS. <br /> fir <br /> �r art/r �vrri <br /> fleneratorlAut'torfsod Agent $Ion date <br /> SITE INFORMATION <br /> C 1805 Harbor St GROSS <br /> Stockton TARE <br /> Ca NET <br /> TOTAL GALLONS ' <br /> ti <br /> TRANSPORTER INFORMATION <br /> Truck ID: <br /> NOR CAL OIL J <br /> Driver: <br /> Print lull name %1gn date r <br /> TIME OLn' <br /> TIME IN <br /> TIME SPENT <br />" � r <br /> DISPOSAL FACILITY INFORMATION EPA ID:CAL 000032658 <br /> Seaport Environmental Approval Number Solids%VA pH <br /> 676 Seaport Boulevard 302 169 <br /> Redwood City, Ca 94063 <br /> Phone: (850) 394 1024 <br /> I <br /> Solids Surcharge <br /> ¢/USG N 10 <br /> i ',r Irl <br /> Print full name&sign date <br />