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� 4 <br /> V <br /> 6. NON-HAZARDOUS MATERIALS HAULING M'ANI'FEST <br /> NAME j LOT 0, bO <br /> ADDRESS -560 -W W. -mahave PHONE NO. (602) 352-6388 <br /> CITY,STATE.f1P 2hQQnjZ- Az Q5031 <br /> G CONTAINERS. NO— VOLUMZI Q,y-U WEIGHT-1200 tons <br /> E TYPE. TANK--,_ DUMP DRUMS CARTONS ,OTHER— <br /> N WASTE DESCRIPTION GENERATING PROCESS <br /> E COMPONENTS OF WASTE PPM COMPONENTS OF WASTE PP1F"_ <br /> R aj .=s$3 8500 13-&alt Tn I uenev <br /> A racl is��_._ 5e� 4-txz.�c, Pte) _xY]..ems— <br /> T Etby] M ✓ <br /> O <br /> PROPERTIES P1�` SOLID--x-- LIQUID SLURRY OTHE <br /> wR , <br /> HANDLING INSTRUCTIONS <br /> x E O ERMFIES THIS WASTE AS DESCRIBED IS 100%NON-HAZARDOUtS, <br /> B DATE L <br /> GNATORE 6PRINT ORTYPE FULL NAME <br /> i <br /> COMPANYAME�iarrpr. rnmPG „- PHONENO. 707 374-2881 <br /> H <br /> A ADDRESS--R---Q--BaxK SERVICE ORDER NO <br /> U CITY.STATE,ZIP PICK UP DATE�I ,[91 <br /> TRUCK LD NO.-) TRAILER NO � � � � EPA ID NO <br /> R DRIVERy i* �cr, /� w A :;c, � ��J.�1--DATE <br /> .°, <br /> SIGNATURE PRINT OR TYPE FULL NAME <br /> PROCESSOR : <br /> PORT COSTA MATERIALS,INC DISPOSAL METHOD-THERN-AL REMEDIATION <br /> 9000 CARQUB62 SCENIC DRIVE <br /> PORT COSTA,CA 94569 PHONE (415)602-1200 <br /> IF MOVEMENT BY OTHER THAN TRUCK,CALL FOR APPROPRIATE FORM <br /> wr 1991 p c m <br /> mss •���• <br />