Laserfiche WebLink
PACIFIC m <br /> AN ALLIED WASTE COMPANY <br /> Client: �G a r a �'y1C(� Landfill: a r W a r <br /> Contact: Generator: N S u <br /> Phone#: Sales Person: <br /> Quantity: M q 0 Site: /;l 3 Q✓ice r.2 + <br /> Reviewed By: C1 . Address: <br /> Waste Profile Form -ff'Rccept Job# <br /> Chain of Custody ccept Approval#: <br /> ❑ Gasoline Contamination ❑ Ash <br /> TPH-g _ ❑ Accept TTLC CAM 17 Metals 0 Accept <br /> BTEX ❑ Accept pH 0 Accept <br /> TTLC Pb ❑ Accept <br /> ❑ Diesel/Virgin Oil Contamination ❑ Hydraulic Fluid <br /> TPI-Id ❑ Accept TPH-hf ❑ Accept <br /> BTEX ❑ Accept BTEX 0 Accept <br /> TTLC CAM 5 Metals 0 Accept <br /> ❑ Waste Oil Contamination ❑ Sludge <br /> TPH-g 0 Accept TTLC CAM 17 Metals 11 Accept _ <br /> TPH-d ❑ Accept VOCs ❑ Accept <br /> TOG ❑ Accept SVOCs ❑ Accept <br /> VOCs ❑ Accept Paint Filter ❑ Accept <br /> SVOCs ❑ Accept TPH 0 Accept <br /> TTLC CAM 5 Metals ❑ Accept Reactivity, pH ❑ Accept <br /> PCBs ❑Accept <br /> ther a ❑ Treated Wood <br /> me a S <br /> ORGANICS TTLC/TCLP PPM Metals TTLC/STLC PPM <br /> TPH Gas Antimony Mercury <br /> TPH Diesel Arsenic Molybdenum <br /> TPH Motor Oil Barium Nickel <br /> Other: Beryllium Selenium <br /> Benzene Cadmium Silver <br /> Total T.E.X. Chromium Thallium <br /> Total HVOC's Chromium 6 Vanadium <br /> Total SemiVoc's Cobalt Zinc <br /> Other: Copper <br /> Lead <br /> NOTES: <br /> �rp rgVa DATE: / Q� <br /> DISPOSAL: CLASS II /0-7-sc. ElSOIL <br /> PRE-LIEN YES Check w/Management <br /> a-6,4-( <br /> 1145 WEST CHARTER WAY, POST OFFICE BOX 6336 <br /> STOCKTON, CA 95206 <br /> 800.204.4242/FAX 209.466.1067 <br /> www.disposal.com <br />