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Z00121 IML ON XH/Yll 8i+ 61 I11i.L 1+0/07/50 <br /> N2 2059 <br /> NON-HAZARDOUS WASTE DATA FORM <br /> SBC/Pac-rfic Bell <br /> NAMESBC-/Pacific Bell Site- Trac <br /> ADDRESS 2600 Camino Ramon Room 3EOOO 10 East 12,n Strect <br /> CITY STATE n Ramon,CA 94583 Tracy,CA PHONE NO I .� <br /> Q <br /> OCONTAINERS NO VQLUMEJCY wEIGHTITONS <br /> Q <br /> cc <br /> W TANK DUMP <br /> WTYPE ❑ TRUCK ❑ TSIUCK 1P DRUMS ❑ OTHER <br /> WATER <br /> Y Groundwater <br /> m WASTE DESCRIPTION GENERATING PROCESS <br /> COMPONENTS OF WASTE PPM% COMPONENTS OF WASTE PPM% <br /> W <br /> H <br /> L WATER 99-100% a <br /> a <br /> O z TPH < t% 4 W O -9577 <br /> U <br /> Uj <br /> m SITE ADDRESS <br /> PROPERTIES pHrf_fd ❑ SOUO Qr UOU10 ❑ OTHER <br /> Wear appropriate protective clothing <br /> HANOLING INSTRUCTIONS <br /> F <br /> HE GENERATOR CERTIFIES AT46�:HE WASTE AS DESCRIBED IS I.ON 'goaj <br /> -HAZARDOUS TYPED OR PRINTED FULL NAME&SIGNATURE -- DATE <br /> NAME <br /> UA <br /> Cr. ADDRESS �_ • "' <br /> NCITY STATE ZIP. rL C " i PICK UP HATE !, p <br /> PHONE NO �` y fq� 2ZZSr <br /> H � o <br /> TRUCK UNIT 1 D NO TYPED OR PRINTEfi FULL NAME&SIGNATURE ATE <br /> LL LI Crosby&Overton <br /> NAME <br /> J 1630 W 17'h Street Z/ <br /> QADDRESS PROFILE NO <br /> Long Beach,CA 90813 <br /> 0 CRY,STATE Z!P <br /> z 562 432-5445 <br /> PHONE NO - <br /> W <br /> TYPED OR PRINTED FULL NAME 8 SIGNATURE DATE <br /> -d Di6L-6BS-6b6 dtrtr =60 b0 02 rLw <br />