Laserfiche WebLink
ON-HAZAR[iG�S SPECIAL:WASTE �-A <br /> N waste is asbestos waste,.complete Sections LII,In and IV. N <br /> If waste is NOT asbestos waste,complete only Sections L II and In. N 0 <br /> GENERArm(Genaratarcomplates it ofsectionq i` . ..,.„.. <br /> . Generator Name: ARCO PRODUCTS COMPANY b. Generating Location: ARCO STATION #04932 <br /> POB 5077 16 E. HARDING N <br /> Address - d. Address: <br /> BUENA PARK, CA 90622-5077 STOCKTON, CA <br /> Phone No.: (925) 299-8891 PAUL SUPPLE f. Phone No.: N/A <br /> owner of the generating facility differs from the generator,provide: <br /> ). Owner's Name: <br /> ARCO PRODUCTS COMPANY h. Owner's Phone No.: Same ea i(e) <br /> C A 4 O S 06 109 9 02 011 1.1 96 TYPE <br /> WASTE CODE Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> NON—HAZARDOUS SOILB -BAG <br /> Description of Waste: k. Quan 0 0 G Units <br /> � 0 1 T -TRUCK <br /> O -OTHER WRAP BAG <br /> GENERATORS CERTIFICATION: I hereby certify that the above named material is not a hazardous waste as defined by 40 CFR Part 261 or UNITS <br /> any applicable state law, has been property described,classified and packaged, and is in proper condition for transportation according to P -POUNDS <br /> applicable regulations;AND,if M waste Is a treatment residue of a previously restricted hazardous waste subject to the Land Disposal Y -YARDS <br /> Restrictions,I cer iry and warrant that the waste has beentr,ated ip acoordance the requvemerns of 40 CFR Pan 266 and is no longer a M' -CUBIC METERS <br /> hazardous waste as defined by 40 CFR Part 261. tMe reques f ARCO PRODUCTS COMPANY Ya -CUBIC YARDS <br /> r. N I O -OTHER' <br /> MELISSA II:I12N/ DILIARD� <br /> Generator Authorized Agent Name Shipment Date <br /> TmnspbrterT completeeg <br /> S2C1101]�' `..gi TRANSPORTER (Generator complete a-d; Trans rterucom ete h-n) - <br /> TRANSPORTERI TRANSPORTERII <br /> DILLARD TRUCKING, INC. <br /> a. Name: h. Name: -' <br /> POB 579 <br /> b. Address: I. Address: <br /> AV <br /> BYRON, CAff11 94514 <br /> 1 111 ` <br /> c. Driver Name/flge' /V-f/., -- - 'ed4. j...DriverName/Title: <br /> 915-634-685�MfI` E `, �""T <br /> d. Phone No.: e. Trudy Ro.:, k- Phone No.: I. Truck No.: <br /> f. Vehicle I'cense Nn./State: m.Vehicle License No./State: <br /> A",J1kRce'1ofMa rials. Acknowledgement of Receipt of Materials. <br /> 9n.Shl mens Date Drivers' nature Deb <br /> Section III DESTINATION (Generator completes a-d,destination sfte completes e-t) <br /> a. Site Name: CO <br /> BFI — VASROAD SANITARY LANDFILL c. Phone No.: (925) 447-0491 <br /> 4001 N. VASCO"ROAD 4001 N. VA-;CO ROAD <br /> b. Physical Address: d. Mailing Address <br /> LIVERMORE, CA 94550 LIVFIM-ORE, CA 94550 <br /> e. Discrepancy Indication Space: <br /> I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> JiiB# 1007-111 <br /> ra PO# 09-30312 <br /> f Name of Authorized Agent Signaw,e - Receipt Date <br /> Section IV 'ASBESTOS (Generator complete a-cl,f,g,Shipper'completes e.) <br /> a. Shippers's-Name: b. Shippers's"Phone No.: <br /> c. Shipperes-Address: <br /> d. Shippers's Special Handling Instructions and additional information: <br /> CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified. package( <br /> marked,and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations. <br />