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ZS-02 01 33 Seapor-t~ PQtr-oloum 550 3541021 <br /> r <br /> Seaport Environmental <br /> NON-HAZARDOUS WATER TRANSPORT FORM <br /> GENERATOR INFORMATION <br /> CUSTOMER INFORMATION <br /> Amerlcan Valley Waa1P Oil <br /> Port of Stac klor) <br /> 2201 W Wasl,i11g1on St <br /> Stockton Cd P09 <br /> w <br /> 0Em HiPTION r7F wA1LFZ Marulonnq well SamplrnD <br /> t [3 NON f(AZAKOOUS WAyrt WATF-R MI NITORINO WELL PURGE WATER ANDIOR AL1ri£R RtNSATF 1 ANK fIINbAI t eft aDO�F <br /> m,,CRIDED WA1Lk THIS WATER PAY CONTAIN 4 ItINLvEDo ut7F-5 NOT MEETITHECRITERIA OF HAZAR)FINS WASTE A,, <br /> E� IS A LIQUID EXEMPT PHOM RCRA NEft 40 CFR 2014 IbKtOyW <br /> DFSCRIREU IN 22 CCR AHl ICLE 11 OR ANY OTHER AYPLICADLE STATE LAW I-tAb KEEN PROPERLY UCSCRIBE I) <br /> CLAS51FIE0 ANU PACKA(.Fr)AND IS IN{,R(>,5-:R CONOIT!()N FOR TRJWSPORTATION A(,t:ORDiNG TO ArrLICASLE <br /> RF-GUI ATIONS <br /> ���LIL ft v r\ <br /> L,' Iqn dalo <br /> ,„ GCncti(orlAulhorrsod�gsnl <br /> 4 SITE INFORMATION <br /> 2201 W Washlru,)lon St Pg <br /> *r Stockton <br /> y Ca <br /> 7AL GALLONS <br /> n ,4r,u 34 r3 rr,u5, <br /> �I <br /> TRANSPORTER INFORMATION r <br /> Truck to <br /> American Valley Waste Oil ,�}• <br /> j Drives <br /> Print full namo A sign dila <br /> TIME OUT <br /> T11AE IN <br /> r <br /> TIME bF'ENT <br /> r <br /> DISPOSAL FAC1LrTY iNFOWATION EPA for CAL M032068 <br /> SOI,ds %W1 pH <br /> Seaport Envlronmgntal Approval Number t <br /> 675 Saaport Boulevard hoL002 <br /> { <br /> Redwood d CI(y, Ca 04483 <br /> Pne {850) 364 1424 - <br /> f` Solids Surcharge f <br /> FIU t G <br /> � I li <br /> l <br /> Received by <br /> i <br /> Print full name b 3Ign Oele <br /> t <br /> , <br /> t r <br /> a I <br />'l rj'• \ <br />