Laserfiche WebLink
NON-HA�ZAk"MOUS WASTE"""DATA FORM <br /> NAME UNOCAL Marketing evn <br /> P. O. Box '1155 LD.NO, C IA ID 8 12 0 +I 1 13 , <br /> IS <br /> ADDRESS <br /> Site:437 E. Miner Ave. , Stockton <br /> CITY,STATE.ZIP San Ramon Ca 94583 Station 1/0187 PHONE No. 15101377-2368 <br /> C V <br /> 0 CONTAINERS:No. " `� �` VOL ME / WEIGHT <br /> F ` <br /> Q <br /> s <br /> W TANK DUMP <br /> Z TYPE; ElTRUCK Xp 'TRUCK ❑ DRUMS ❑ CARTONS ❑ OTHER <br /> W .< Removal of underground <br /> ('} WASTE DESCRIPTIONSO11 with Waste O11 GENERATING PROCESS tank <br /> } COMPONENTS OF WASTE PPM °6 COMPONENTS OF WASTE PPM % <br /> m <br /> 0 <br /> W 1. Soil 99.9 s. <br /> W Waste Oil <0.1 <br /> J 6 <br /> It <br /> 2 APR <br /> W e. <br /> 5� <br /> CD <br /> OPROPERTIES: Neutral nSOLID ❑ LIOUID ❑ SLUDGE 13 SLURRY ❑ OTHER <br /> X9f { <br /> HANDLING INSTUCTIONS: I Acceptance fit 109 ISt?[Son 20187 <br /> THE GENERATOR CERTIFIES THAT <br /> ry- THE WASTE AS DESCRIBEDAS 100% �, ro, 2. y z <br /> NONHAZARDOUS. /[�JI c L 'J1 /`1A 1� 0 Jt�c•I <br /> ? <br /> APED OR PRINTED FULL NAME d SIGNATURE DATE <br /> 3 Dillard Trucking, Inc. Eo C A D 9 8 1 6 9 2 0 0 9 <br /> NO. <br /> Q NAME <br /> W 143/93 <br /> ~ P. .O. box,218 SERVICE ORDER NO. <br /> 0 ADDRESS <br /> a . Byron, California 94514 <br /> In CITY.STATE,ZIP PICK UP DATE <br /> Z <br /> Q <br /> FPHONE NO. 510 634-68511S ^ 1 /t7 L <br /> TRUCK UNIT,W.NO. ME <br /> TYPED OR PRINTED FULL NA8 SIGNATURE '� DA <br /> EPA <br /> Laidlaw k`avironmenLal Services, Inc. Na C A 6 7 6 <br /> NAME DISPOSAL METHOD <br /> Y ADDRESS 2500 Lokern Road PI LANDFILL ❑ OTHER <br /> ~ s <br /> J Suttonwillov,, California 93206-0787 <br /> V CITY.STATE.ZIP /� /`//] �7 <br /> LL 800 544-7199 D I0 1 / I�'` /�'""� �� <br /> Q PHONE NO. ,/ //I� —'�—� <br /> N l/„nom � ` <br /> f TYPED OR PRINTED FULL NAME A SIGNATURE DATE <br /> t GEN OLD/NEW 'L A {,Ip <br /> TRANS S $..n;. <br /> C/O RT/CD - HWDF ONE DISCREPANCY <br /> I <br />