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v � <br /> EnviroPaciEc <br /> P.O.Box 1053,Vacaville,CA 95696,(707)447-2106 <br /> GEC Lic.No.A-676019 <br /> NON-HAZARDOUS WATER DISPOSAL DOCUMENT <br /> GENERATOR SIT <br /> Name: Gerald Thiemann Name: Former Thiemann's Service <br /> Address: 327 Blossom Drive,Ripon,CA Address: 106 W.Second St.,Ripon,CA <br /> Contact: John Sellman Tel: (209)579-2221 Contact: John Sellman Tel: (209)579-2221 <br /> CUSTOMER <br /> Name: ATC Associates Inc. Contact John Sellman Tel: (209)579-2221 <br /> Address: 1117 Lone Palm Ave.,Suite B,Modesto,CA 95351 Proj.No.: 054.62605.0001 P.O.: W-12-54-0092 <br /> DESCRIPTION <br /> Description of Water. Auger Rinsate <br /> Quantity: a Units: Drums <br /> This non-hazardous waste water is purged groundwater,auger rinse water,sampling equipment rinse water,a combination thereof,or as <br /> described above. The described water may contain hydrocarbons. I certify that the above named material has been properly described and <br /> Yy classified according to applicable regulations and possesses no characteristics that would require its handling as a hazardous/waste. <br /> KGenerator/Authorized Agent: \ <br /> ` riot Namerrtle -!—P gn Date <br /> TRANSPORTER DESIGNATED FACILITY <br /> Name: EnviroPacfc /Name: EBMUD <br /> Address: P.O.Box 1053,Vacaville,CA ((� Address: 2020 Wake Avenue,Oakland,CA \� <br /> Tel: (707)447-2106 Proj.No.: 299 <br /> \This material will be disposed of at the above referenced facility in <br /> accordance with applicable federal,state and local regulations <br /> Removal Date <br /> Driver: 05-IA-t�p Waste Tracking No: 1022 <br /> \ <br /> 1 <br /> rl�h l--���'� EnviroPa <br />