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JUL-28--1998 14 22 ID T WM, INC P 04 <br />' iWM, INC <br /> APPraval No NON-HAZARDOUS WATER TRANSPORT -I"iciaxNo <br /> CERTIFICATE OF DISPOSAL sPD7.3060 <br />' GENERATOR INFORMATION CUSTOMER INFORMATION <br /> Name Southland Corporacion Name IWK Inc <br /> Address 10220 SW Greenburg Rd, 470 Address 950 Ames Avenue <br /> COY, Stm Zip Portland. OR 97233 Crty, State,Zip IVIiI tas, CA 95035 <br /> Purihasc Onus# <br /> GENERATOR CERTIFICATION OF NON-HAZARDOUS WASTE <br /> Descnpnan of Water Excavanan Dewaterm <br />' NON HAZARDOUS WASTE WATER-MONITORING WELL PURGE WATER AND/OR AUGER RINSATE,TANK <br /> RINSATE OR ABOVE DESCRIBED WATER- THIS WATER MAY CONTAIN DISSOLVED HYDROCARBONS I <br />' CERTIFY THAT THE BELOW NAMil7 MATEJUAL IS A LIQUID EXEMPT FROM RCRA PER 40 CFR 2614(B)(10) <br /> AND DOES NOT MEET THE CRITERIA OF HAZARDOUS WASTE AS DESCRIED IN 22 CCR ARTICLE i i OR ANY <br /> OTHER APPLICABLE STATE LAW HAS BEEN PRaFERLY DESCRIBED CLASSWTED AND PACKAGED AND IS <br /> IN PROPER C,ONDMON FOR TRANSPORTATION ACCORDING TO APPUCABLE REGULATIONS <br /> vavly mAs m saunat..4v na4 QL�L--� Z <br />' Generator/ Authonad Agm2 Stgpature Date <br /> SITE INFORMATION <br /> IWM Job 9 Sac# Srte Address #of Drum Galloaas <br /> 14117 2725 W Country Club Blvd, Stockton CA Z g d p <br /> EsmToced Total <br /> TRANSPORTER INFORMATION DISPOSAL FACILITY INFORMATION <br /> Name IWM, Inc Name Seaport Enwrm meuW <br /> Address 950 Ames Avenue Address 675 Seaport Blvd <br />' Mdp>tas, CA 95035 Port of Redwood City CA 94063 <br /> Phone 408-942-8955 Pbczne 650-364-1024 <br /> Truck ID #- C � > I y r <br />' Dnver Name �C_c, ..! ���z`+� ,,L <br /> Slature Date <br /> DOC(TRANPRT FRM) <br /> TOT; L 04 <br /> 1 <br />