Laserfiche WebLink
NO. 935468 <br /> NON-HAZARDOUS WAS DATA FORM <br /> f EPA <br /> ID <br /> NO <br /> NAME Southland Cor oration Sfte:#17334 <br /> PROFILE <br /> 10220 S.W. Greenbur Road 4501 N. Pershing NO ADDRESS iXi <br /> a c' <br /> Suite #470 O2 <br /> CITY STATE zip Portland, OR 97233 Stockton. CA PHONE NO <br /> CONTAINERS No _. _ _ VOLUME WEIGHT nmental <br /> .S�r <br /> TANK DUMP <br /> ,TYPE TRUCK ❑ TRUCK a ❑ CARTONS ❑ OTHER <br /> WASTE DESCRIPTION WAMR GENERATING PROCESS GROUNMA1ER <br /> COMPONENTS OF WASTE PPM % COMPONENTS OF WASTE PPM % <br /> 1 WATFR 99-100 5 <br /> 2 Teti c 1 s <br /> O <br /> ,� 3 7 FiEST#19220.02 <br /> 0 4 8 <br /> r PROPERTIES pH�_ ❑ SOLID 9 —VQUID ❑ SLUDGE ❑ SLURRY ❑ OTHER <br /> t HANDLING INSTRUCTIONS Wear appropr tate project !vc ing <br /> r <br /> THE GENERATOR CERTIFIES THAT THEWASTEp <br /> NON HAZARDOUSSCRIBED IS 100/6 Larry Moot Jar <br /> [lF3ta.STSouthland t <br /> TYPED OR PRINTEO FULL NAME&SIGNATURE DATE <br /> EPA <br /> ID <br /> NAME Nit-to & Sons NO <br /> ADDRESS 1281 Brea Cyn Rd SERVICE ORDER NO <br /> (y�y <br /> ZCITY STATE ZIP Brea. CA 92621 PICK UP DATE �✓ <br /> J it <br /> l—y PHONE NO 714--990-6855 <br /> TRUCK UNIT I D NO NSE FULL AME&SIGNATURE 7 }1 t4 ATE <br /> 1 r EPA F <br /> Na <br /> NAME <br /> DeMenno Lerdoon NO ' <br /> DISPOSAL METHOD <br /> + ADDRESS 2000 N. Alameda i t . ❑ LANDFILL x OTHER <br /> CITY STATE ZIP Compton, CA 90222 <br /> _ PHONE NO 310-537-7100 <br /> V <br /> rLL <br /> D TYPED OR PRINTED FULL NAME&SIGNATURE DATE <br /> GEN OLD/NEW L A TONS <br /> TRANS S B <br /> RTICD HWDF <br /> C!O NONE DISCREPANCY <br />