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1 ]N-FLA aARDOU� Vaste eHauler Document Daily Fleld.Tiaket No., ` ` <br /> • ' <br /> GEPRAT®R DEIGN4TED TSD,: AILITY " ALTERNATE,' D5 FACILITY <br /> Name _ <br /> EISA# — -- �'EPA'# SPA# <br /> Address . ff --- A€9ciress. r ,. Address: <br /> Order Placed: Qrder da3e <br /> WASTE l} 1 ,'RILLING MUD ❑ GA WELL WATER - OTHER,_g; <br /> Weight/Volum _ Unitsr `r 'Contair► r: 0 - Gump Trok'. ® = Tr [c TrucK <br /> hrs ilia4riif is northa{ardous because: <br /> I rt is a drilling'Mud Containing only the addttiyes!+s€eo by the PePartrhent tn,itsexemption <br /> le rano contains no significant eonceniratrotta.a,toxic,ir ateriais from.natural sources,or ((r . <br /> 2)!1 ,SUliur-dioxide scrubber solution from d SQdi rYt hidroxise'or'soOium carbonate oil z x. ; <br /> fie€ti *tw,scrvbbar system ,and Poasease8'napCharacYeristics that would require its sfGN.t?1�R1 of aurr+OR AGENT <br /> DATE` <br /> handling as a hazardous waste, <br /> S <br /> TRANSPORTER <br /> Warren E. rornes:' xc 'Inc. Jola Nc� ,a,> p�c(C Op La�t �" E <br /> P:0 Box 369,9457 <br /> 6 <br /> �itf5 Ilia,`C,N`�94571 <br /> Unit ND. ^, <br /> (,q,7}.374-2881 sf ct <br /> TURE .dui € <br /> EPA#CAD076557$70 <br /> Meths of DisPon <br /> ni <br /> Risme QTY Measured _ `Landfill <br /> 13 - Land Treatment, <br /> EPA's# © - BBL 0 - TONS : 'O -OTHER ., :,0 - Surface Impoundment <br /> s - Qther I <br /> St6NATilAEf]FAU7F+D1{{!ED-AGG{i1T - DAT <br /> T DIF TO GENERATOR <br />