ARCHIVED REPORTS_XR0010357 - Laserfiche WebLink

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' RGV BY ROY F. WE570N+ ING, F11- 5-81 + 2'21PM YOB;6506311 57MKTONi CA;$ 4 SECTION Et ASBESTOS Indicat• containment for acbeatoe, ' 0 bags 0 cartons 0 drums ❑ wrapping C other "Tt , Al oshastoe must be preparea for tiansportation to and disposal at tha ' Forward Landfill in accordance with all applicable regulatory requirements. SECTION F: SHIDpING INFORMATION Method: ❑ Sulk Liquid ❑ Bulk Solid containerized (type) : SS 4a/ Ski/drams W/ 1-,c6r Quantity; IS X Cubic yards ❑ gallons ' per ❑ month ❑ year x one time only ❑ other ' NOTE: All shipments mast be approved by the Forward, Inc. Environmental Compliance officer or Solid waste Coordina:.or prior to delivery, SECTION G : CERTIFICATION/INDEMNIFICATION STATEMENT ' The below-mined company warrants that the above and any attached or submitted wagts ctaractcritaticn is complete and accurate and that based upon testing And analysis performed on the uaeta materials, none of the Haste materials are ' hazsrdoLs as defined by 40 CFR, Part 261, and the California Cade cf Regulations, Title 22 , with the exception of asbestos which is properly described in sections E and F above. In the event that any portion of the waste materials other than oabe5tc6 properly aescricea in settlors 1, and F above) ,e deterrr_ned to be hazardouz ("Hazerdoua maters ale") according to any or the above mentioned regulations, each party shall notify the other in writing immediately upon learning of such determination The telow-namod coronary shall within ten (14)' days after receiving tLch written notification reoArd-rg a hazardoum ' oetermination, and at the below-named company' s enle expense, from the Forward Landfill and properly dispose of them elsewhere. V e below-named company warm--ts that any asbeetos delivered to the Forward Lanafili has been properly deacrired in sections E and ? above and has been prepared for transpertatlon to ' and d.sp-)sal at the For+,ara Lsndf�ll =n full compliance with applicable regulatory roquircnonte the bzlo4-named company shall defend, indemnify and save harmless Forward, Inc _tP affiliates, treix officers, directors, aoents, represent atLves and employees and their successors and assigns fron any limb-lity, claims, losses, damages, date, liens, JU09"lents, ordere, government direct,ves, or expenaeF of any kind in oonnectior with the hazardous materiale and/or non-conforming waste anO in ' connection s..1th any breasts cf tha bolo.-named compary'a warrant,-e8 given or the below-named company's obligatLons undertaken heroin The belo4-named company agrees that, an the event ttet it learns that the waste ' constituents vary from trose set forth above or on any sttacred or submitted documents, it will immediately suamit a corrected waste characterization forth. CCMPAN f s 52 `J (/ BY. (Print Inane) TITLE. Id L t?jkkjt SIGNAitgE; PATE: Z--