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J'U1 lI 02 02: 17p Olde Lockefor-d Winery 2❑9 2"7 9773 <br /> 07i11f02 THU 14:01 FAX 510 2821 EBISLID SOURCE CII. 100 z 2 <br /> TRUCKED NON-HAZARDOUS W .;ST'E <br /> aBMUD DISPOSAL PERMIT Terms and Conditions <br /> Uquid Waste Acceptance Agreement <br /> t) Permit Holder. Copperford, LLC <br /> 1.) Permit Number: 2241 � <br /> 3) Discharge Number: 2241 A I <br /> i <br /> 4) Source of Material to discharge: <br /> Company Name Address Material Composition Estitrwted Volumc <br /> (gallam/meawared ureic <br /> Copped'ord,LLC 11470 Locke Road,Bldg, 100 Wintry waste{99"/. <br /> Lock-ford.CA 95237 WateX& I%wine ICCS <br /> S) Transporter Inforination <br /> Fransportorpany Narrycand 'Frock Descrip6 n Truck Truck t.D. Tractor I.D. Tank <br /> l:-icerssc N+mlber Number Cipaeily <br /> Number allons Linc Ste Artachmcnr <br /> 6) Dtseribe known and potential pollutants in this Waste <br /> Winn Lccs,%MSS,Bantonite i <br /> 7) Fens for Dischaxge of Trucked Wastc <br /> Copperford, LLC shall pay$1111gAILU,for hauled truck Waste discharged to the <br /> EBMUD W WTP. The fees billed for the discharge will he calculated based upon the <br /> full volume of the transport vehicle. The DiArict will bill waste transporters monthly. <br /> Permit)Fifal r s Signature <br /> _ <br /> g at Date <br /> I <br />