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..A.CER 'TRACTOR SERVICE ' , <br /> NON—HAZARDOUS MAMFES1 <br /> GENERATOR NAME fA)R CAL BEVERAGE <br /> GENERATING LOCATION- SAF11: e <br /> CITY, STATE & ZIP PHONE}# <br /> 209-943-0581 <br /> CONTAINERS: NO. VOLUME WEIGHT 0: <br /> TYPE: TANK TRUCK DUMP TRUCK, DRUMSOTHER# <br /> WASTE'DESCRIPTION: S0ILF : -. <br /> GENRATING PROESCM .. <br /> _ i <br /> YAC <br /> o D CRIPTION OF WASTE QUANTITY 'TYPE <br /> 2. <br /> r� T <br /> :f, <br /> PROPERTIES: PH SOLID LIQUID SLUDGE SLURRY OTHER <br /> It <br /> HANDLING INSTRUCTIONS: <br /> THE GENERATOR CERTIFIES THAT THE WASTE AS DESCRIBED IS 100%NON-HAZARDOUS AS a <br /> DEFINED BY 40 CFR PART 261 OR ANY APPLICABLE STATE LAW, AND HAS BEEN PROPERLY <br /> DESCRIBED, CLASSIFIED AND PACKAGED AND IS INPROP $_CONDITION FOR TRANSPORTA R <br /> TION ACCORDING TO APPLICABLE REGULATIONS. <br /> t C f] <br /> rTyped or Prinle:6 Full Nam. SI ature : Date <br /> NAME PLACER TRACTOR SERVICE TRUCK # <br /> ADDRESS P.O. BOX 170 DRIVER NAME <br /> a. CITY, STATE & ZIP LOOMIS,CA. 95650 SERVICE ORDER # <br /> PHONE --916-657-5535 <br /> f <br /> Typed or Printed Fu1T Name and Signature f Dat <br /> DISPOSAL FACILITY PHONE # <br /> HULa916-383-2122 <br /> O <br /> ADDRESS R DISPOSAL METHOD <br /> 97 JACKSON ROAD <br /> P CITY, STATE & ZIPz _ LANDFILL OTHER SACRAMENTO, 95826 <br /> A Typed or Printed Full Name and Signature" Date r <br /> DISCREPANCY: - <br />