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- F <br /> y <br /> NON-HAZARDOUS WASTE DATA FORM 5 � ry <br /> �. <br /> .ulor Spot Co. <br /> - + NAME <br /> 5400 E Harney Lane �o <br /> ADDRESS NO _ <br /> j urrSTATE.ZIP Lodi. California 94520 109 333-0235 <br /> PHONE NO. i <br /> I CONTAINERS:.. r t' ' <br /> E VOLUME V4 4L WEIGHT <br /> TYPE: ❑ TRUCK �.TRUCK <br /> C3DRUMS ❑ CARTONS ❑ iTHER <br /> w Soil with diesel <br /> 1.100 ppm Tank Recoval <br /> WASTE DESCRIPTION GENERATING PROCESS <br /> _. <br /> 7, <br /> m COMPONENTSOFWASTE PPM e6 COMPONENTS OF WASTE PPM <br /> Soil 90A s <br /> w diesei 3.100 1� <br /> UulT <br /> PROPERTIES: 00-RbOLIO ❑ LIQUID ❑ SLUDGE ❑ SLURRY ❑-OTHER <br /> 6� HAwauNGINSTucnDNs Approval =120185-286 <br /> r <br /> - THE GENERATOR CERTIFIES THAT <br /> THE WASTE AS DESCRIBED IS 100% �, ! <br /> NON-HAZARDOUS. <br /> T•w�r <br /> TYPED OR PRINTED FULL NAME A SIGNATURE - DATE t <br /> Dillard Trucking, inc. EPA j 1 <br /> y D <br /> �I .1 NAME _ - NO. I <br /> Ll Route 1 Box 73 <br /> AGGRESS SERVICE ORDER NO. <br /> s4 a Byron. California 91511 <br /> a� _ <br /> ;1 ?. CITY,STATE,ZIP' PICK UP DATE <br /> 1 <br /> At <br /> c�roNENo. I �113 634-0'561 <br /> r - f ie C <br /> TRUCK UNIT.1 D.NO I i•- T" TYPED OP PRINTED FULL NAME 6 SIGNATURE DATE <br /> _ <br /> Liquid Waste Management.t. Inc. p� C 1 D 9 8 0 u 3 8 8 3 i <br /> Mk 1 I NAYS... NO. <br /> Route Box-4- _ DISPOSAL METHOD <br /> xoua€Ss - <br /> LANDFILL- TOTHER <br /> t4 1 `!cKittrick. Ca. 93251 <br /> CtTY•STATE ZIP <br /> i 805 762-7366 <br /> PHONE NO. <br /> TYPED OR PRINTED FULL NAME S 51ONATURE '+''GATE- - <br /> r x <br /> GEN - - OLWNEW L- A TONS .;.'•. <br /> F ! - TRANS - S -8 <br /> Gt` III <br /> C10 RTXO I HWOF NONE - DISCPEPANCY <br /> >J <br /> IS HIM <br /> r. <br /> , <br /> fist ' <br />