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08/12/2009 11:52 4084339511. IWM INC j PAGE 03/04 <br /> f <br /> na <br /> I <br /> IWcQMTCD WAnrCLTRCAM MANADMM,INC. <br /> 1945 CONCOURSE DRIVE,SAN JOSE,CA 95131 <br /> PHONE:408.433,1990 FAX: 408.433.9521 <br /> I <br /> CERTIFICATE OF DISPOSAL <br /> Generator Name: Dhoot/City of Lathrop Facility Name: Dhoot/City of Lathrop <br /> Address: 15600 S. Harlan.Road Address: 15688 S. Harlan Road <br /> Lathrop, CA 95330 Lathroe, CA 95_330 <br /> Contact: Dalwinder Dhoot Facility Contact: Allan Dudding, Stratus Environmental <br /> Phone: 209.982.0376 Phone: 530-676-6004 <br /> I WM Job#: 98762-DW <br /> Description of Waste.. <br /> 1 Drum(s) of <br /> Non-Hazardous <br /> Water <br /> Removal Date: 8/10/09 <br /> Ticket M.. SP100809-MISC <br /> n nformation Disposal Facility Information { <br /> Name= IWM, Inc. Name, Seapurt Refining& Envill,nunerttal <br /> Address: 1945 Concourse Drive Address: 700 Seaport Blvd <br /> San Jose, CA 95 13 1 Redwood City, CA 94063 <br /> Phone: (408) 433-1990 Phone: (650) 364-1024 <br /> IWMI, INC. CERTIFIES'FRAT THE ABOVE LISTED NON-HAZARDOUS WASTE WILL HE <br /> TREATED AND DISPOSED AT THE DESIGNATED FACILITY IN ACCORDANCE WITH <br /> APPLICABLE f EDERAL, STATE,AND LOCAL REGULATIONS. <br /> William T. Delon 8/10/09 <br /> Authorized Representative (Print Name and Signature) Date 1 <br /> CcHOIDisp�nal.blankficld.scapDAuw - Rcviscd:041006 <br /> } <br />