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1 <br /> t <br /> Generator Information <br /> Name National Freight <br /> Address 2850 Loomis Rd Stockton <br /> ' Description of water Non-Haz purge water UST Sites <br /> Non-Hazardous waste water mon Wring well purge water and/or auger rmsate,tank ansate or above described water This water may <br /> contain dissolved hydrocarbons I certify that the above named material is a liquid exempt from rcra per 40 efr261 4(b)(10)and does <br /> not meet the criteria of hazardous waste as described in 22 ecr article I 1 or any other applicable state law Has been properly <br /> described Classified and packaged and is in proper condition for transportation according to applicable regulations <br /> Generator/Authorized agent <br /> ' Print sign date <br /> Transporter Information <br /> ' Company name American Valley Waste Oil <br /> ' Truck Id _2 Driver <br /> Print sign date <br /> ' Total Gallons <br /> Facility Information <br /> Cascade General Inc Approval Number 800-934 <br /> SSSS N Channel <br /> ' Portland, OR 97217 <br /> ORD 18761934 <br /> Via Railcar 4 <br /> ' Received by <br /> Pant full name and sign date <br />