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81201 <br /> fNOBalHAZARDOUS WAS a E DATA FORM <br /> I <br /> NAME C-RELL PllPJkk NE COU.PA#IY L;.P At . WNDRA BIEi#YEI <br /> F P.O.BOX 2CA0,TSP i606-A � <br /> ADDRESS I <br /> r <br /> CITY,STATE.ZIP. UST f � v 60 PHONE HO. I 12:0 2A 2C <br /> �. 'CONTAINERS:No. - _ VOLUME WEIGHT <br /> I' <br /> 3TYPE: ±D'TA NK <br /> K E]RUUCK <br /> MP 0 DRUMS D CARTONS -.0'OTHER <br /> W <br /> 0 WASTE DESCRIPTION `R� �'IT_T�$ I� .04DnER&rSGENERATING PROCESS <br /> COMPONENTS OF WASTE PPM 46 COMPONENTS OF WASTE. ; PPM 46 <br /> Lu ,. <br /> S. <br /> dl•}l! F,1iCl:ti WATDI K'A4 1tl >rivku,IWMI kj-D ANN Sl Ult1J•r a eftxl FIUNIit'i"—""' <br /> tJp01.;A.1 IXEATNOU.T OR kFYJSE C11050Y A 0;'t7iTUY.l:�C,i1P(•RXL 511E FACiInY Vy1 JL <br /> 2 'iFF5t;4/ c7F.i�T[117fF11.f3YITiSOFS'ARTaiENTOFTOXIC4Ub3TANCECO:jfHOL.TOG£T1(Fyt -- -_-- <br /> �, iJu, TlIF.1},VgtON41�rrh1 FR{YCEL�IION AGK.YC T CbSOTAvcz_v 1t1taEfIt0VLS[8►i3-(??F—" <br /> " M FLESOUBCE C0NS1N"-10N A??O AFC(fVFRY ACS OF k976 TOCE1i 11kR W1TN APPt.1bAelz <br /> 4" <br /> © 3• AXAL AND STATE t2Jr[IU A'no1y$' CRO 51<1' A OYFAT4y ]ii5 ,AlL qF T1 tjF(1 S��Jt1 <br /> 1 1iR:..uii..7lf3:lr' le�.^.'.'.'."^ <br /> 4 y,% S TO AC(x-I'f iilti REFI-VfiK[�31 . <br /> W - $ <br /> PROPERTIES:' pH I] SOLID D,LIOUID D. SLUDGE D SLURRY D OTHER <br /> 2A4�'Mift rI,1Eii�"a`f`+ Y"f�If0;4,+,frP.L4 r i�C X42€- 3t�C#.CIf3 t9T d C r <br /> i•IANDLING INSTRUCTfONS: <br /> I <br /> r i <br /> i TB.k.r 9v .V�k V i� t. t A+a S 4 1►�,t, i <br /> ramµ Ck u151n TYPED OR PRINTED'FULL NAME&SIGNATURE `> DATE <br /> 5 I <br /> f 1f 14AME tt 3"I YF,U Khat: <br /> ' E4 <br /> 0 ADDRESS; ` 11:`;t3I+ ?11t MADSERVICE ORDER NO; <br /> #. <br /> CL WATWNVILL1, CA 23-97f <br /> uCITY,STATE,ZIP PICK UP DATE <br /> PHONE 210AM6 : <br /> TRUCK.UNITJ.D.NO. + TYPED OR PRINTED FULL`NAME'a.SIGNATURE " DATE <br /> 002 <br /> D15POSAL METHOD / <br /> ADDRESS` J O'aNOFILL CI OTHER <br /> L0141 BlAt'N CA will <br /> (J CITY,STATE,QIP ? 1 <br /> LL <br /> PHONE NO. Ui 5,577 411-5,445 <br /> p TYbED OR PRINTED FULL NAME e SIGNATURE DATE <br /> i <br /> GEN " OLDlNEW L A TONS <br /> TRANS ! S , B ; <br /> cip RTICD HWOF NONE DISCREPANCY <br /> PLEASE RETURN THE GENERATOR COPY � <br /> i RECEIVING SITE SENDS TC}'G ,. ,, -.1'0 THC HOUSTON ADDRESS ABOVF � I <br />