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M Sep -10. 2004 4:29PM WrL.Lht Environmental 832-5152 <br />Permitted Disposal Slw. Wes4 eoos+ ,66e, iPoeet <br />No,4242 P. 5/5 <br />Nam® <br />. 8()k- C2,36g cit �� ' _ Zip 3� <br />Address_ v <br />Phony. <br />No.CROI W-9379 . <br />Hauler RegWration # (if hauled as <br />hazardous)_ CA '7/�31�,CIv/�� <br />c. iank/Rping Disposal site: <br />Name_ <br />i Zr <br />f r <br />Phone, <br />EPA D., _ permitted TSO <br />4 <br />-71,931 <br />9. Is the sampling finn an independent third party from the contractor? kt&� <br />dui:i ,a! 2(A . ' M I1/It; ,15M.- iiaTO'wvri, I � <br />t `v <br />�f f r:v -t a <br />YES `~ <br />NOJK <br />Al be ♦♦ • <br />11. Hwidling of excava%d soil: <br />a) What maWalMll be used to line ft tank pit and ower the stockpile? <br />EH 23 046 (Revised 10/16/03) Page 5 <br />