Laserfiche WebLink
f <br /> Y <br /> RESIDUAL INFORMATION PICK UP RE UST <br /> SHELL TERMINALS.AND PIPELINE 8039-7 <br /> This form must be filled out completely and all required analyses attached. FAX or E-MAIL to the . <br /> Residual Disposal Coordinator for characterization and transportation of material. <br /> RDC AREA PHONE FAX <br /> Sherell Heidt CA,HI,OR,WA- 7131241-5036 7131241-7646 <br /> Nancy Groves AL,LA,CO,EL,IN,KS,KY,Ml,MS,MT,OH, 713/241-0858 713/241-2997 <br /> TX <br /> SITE INFORMATION <br /> Site Contact: Jose Zavala Jr. <br /> Region/District/Area: Western Phone: 209-244-3601 Fax: 209-835-5974 <br /> Facility Address: 25705 Patterson Pass Rd. <br /> { City: Tracy State: Ca Zip. 95377 County:. San Joaquin <br /> Location Number: Tracy Station <br /> Incident No.: Charge Code/SAP/Expense/AFE 10011271 <br /> Send invoice to Name: 'Domingo Nunez Address 25705 Patterson-Pass Rd. <br /> City: Tracy State: Ca Zip: .95377 Telephone: 209-834-8789 <br /> Material Description: Free Liquid ❑ Yes ® No Project x Remediation ❑ Spill❑ . <br /> Oily Gravel and plastic <br /> Process generating this residual: (Be specific-for example:blasting of floor of crude oil tank 306) <br /> General Maintenance <br /> k <br /> Accumulation.Date: 9-30-09 Sampling Date(if applicable) <br /> Type of container: Drums--How 1 Type: 55 Gallon open head ring lid <br /> many <br /> Drum ID Numbers: D-2 <br /> Bins—How many Size: Volume in Bin <br /> ' Size: Volume in Bin <br /> Bin Supplied Bin. <br /> r by: Numbers) <br /> Bulk pile Size (cubic yards) <br /> Othe' <br /> i <br /> t <br /> r <br /> Any special requirements for drum pick-up? (Rusty,missing parts,leakers, no <br /> etc.) <br /> e <br /> Comments/Local Vendor <br /> Suggestion: <br /> no <br /> Form filled out by: Jose Zavala Jr. Date: 10--05-09 <br /> Phone: 209-244-3601 Fax: 209-835-5974. <br /> 4 <br /> w r <br /> 1 <br /> k <br />