Laserfiche WebLink
PACIFIC REGIONAL LANDFILL <br /> AN ALLIED WASTE COMPANY <br /> Client:r Landfill: �77f'�" ` <br /> Contact: Generator: � �'✓ ' <br /> Phone Sales Person: <br /> Quantity: Site: <br /> Reviewed By: ✓ Address: ',:l 8 4 <br /> Waste Profile Form 7AZcept Job# <br /> Chain of Custody ccept Approval #: <br /> Gasoline Contamination ❑ Ash <br /> TPH-g "crept TTLC CAM 17 Metals ❑ Accept <br /> BTEX G/Accept pH ❑ Accept <br /> TTLC Pb -Accept <br /> ❑ DieselNirgin Oil Contamination ❑ Hydraulic Fluid <br /> TPHd ❑ Accept TPH-hf ❑ Accept <br /> BTEX ❑ Accept BTEX ❑ Accept <br /> TTLC CAM 5 Metals ❑ Accept <br /> Waste Oil Contamination ❑ Sludge <br /> TPH-g ❑ Accept TTLC CAM 17 Metals ❑ Accept <br /> TPH-d ❑ Accept VOCs ❑ Accept <br /> TOG ❑ Accept SVOCs ❑ Accept <br /> VOCs ❑ Accept Paint Filter ❑ Accept <br /> SVOCs ❑ Accept TPH ❑ Accept <br /> TTLC CAM 5 Metals ❑ Accept Reactivity, pH ❑ Accept <br /> PCBs ❑Accept <br /> ❑ Other ❑ Treated Wood <br /> ORGANICS TTLC/TCLP PPM Metals TTLC/STLC PPM <br /> TPH Gas 777 Antimony Mercury <br /> TPH Diesel Arsenic Molybdenum <br /> TPH Motor Oil Barium Nickel <br /> Other: Beryllium Selenium <br /> Benzene ;t•,/ Cadmium Silver <br /> Total T.E.X. :°tom; Chromium Thallium <br /> Total HVOC's Chromium 6 Vanadium <br /> Total SemiVoc's Cobalt Zinc <br /> Other: Copper <br /> Lead <br /> NOTES: <br /> DATE: ;— � <br /> DISPOSAL CLASS II SOIL <br /> PRE-LIEN YES NO Check w/Management <br /> 1 145 WEST CHARTER WAY, POST OFFICE BOX 6336 <br /> STOCKTON, CA 95206 <br /> 800.204.4242/FAX 209.466.1067 <br /> www.disposal.com <br />