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Jun-19-02 23: 50 Seaport Petroleum 650 3641021 P. 02 <br /> 1 Seaport Environmental <br /> �r NON-HAZARDOUS WATER TRANSPORT FORM <br /> 1 GENERATOR INFORMATION CUSTOMER INFORMATION <br /> Stoodley &Sws,Rlpoii FSrms, rinco Truck Amer€can Valley Waste Olt <br /> 850 Mllgen 22087 Hwy 9 2259 06 Hwy99 <br /> ' Ry)on Cj PO# <br /> ' D61;CRIPTION01-WATER Monitoring Well Sampling <br /> NON-HAZARDOUS WASTE WATER MONITORIN(,WELL PURGE WATER AND0>4 AUGER RINSAi E,TANK RINSATE OR AROYL <br /> DESCRIBEI)WATER THIS WATER MAY CONTAEN DISSOLVED HYDROCARBONS I(ERTIFY THAT Tr IL AOOVE NAMED MATFWAL <br /> I%A L[OUIC)FxEMpi mOM Rt RA PER 40 rFK lbl 4(b)(10)ANU DOES NOT MEET THE CRITERIA OF HAZAROOLIS WAST 1-AS <br /> DFS(RIOCD IN 27(CK ARTICLE 11 OR ANY OTHER APPLICARI E STATE LAW IFAS BEEN rROPLRLY DESCRMI_u <br /> 1 CLASSIFIED AND PALKA(:ED AND IS IN PROPER CONDITION FOR TKANSFORTATION ACCORDING TO APPL€CABLF <br /> RE_(A)LATIONS <br /> 1 GencraiorlAutharised Agent Sign date <br /> 1 SITE INFORMATION <br /> 850 Mllgcr�22087 Fiwy 99 22506 Hwy99 GRASS <br /> Ripon - — TARE <br /> Ca NET <br /> TOTAL GALLONS <br /> "L,iOieo sit'to❑q pn i ISG <br /> • TRANSPORTER INFORMATION <br /> 'truck ID { <br /> 1 American Volley Waste Oil <br /> Driver <br /> Print full name&sign dale <br /> 1 TIME OUT <br /> TIME IN <br /> TIME SPENT <br /> 1 <br /> DISPOSAL FACILITY INFORMATIOW EPA ID CAL 000032058 <br /> ' Seaport Environmental Approval Number Sollas%Wt pH <br /> 675 Seaport Boulevard 302 - 1028 <br /> Redwood City,Ca 94063 <br /> ' Phone (BSO) 364 1024 I. <br /> Solids Surcharge <br /> ' fIUSG <br /> Received by <br /> ' Prim full name&sign date <br /> i <br /> 1 <br /> 1 <br />