Laserfiche WebLink
i • i <br /> SOURCE RECORD BILL OF LADING WELL I D GALS WELL I D GALS�I <br /> FOR NON-HAZARDOUS PURGEWATER RECOVERED FROM ! h w / Q0 . 0 <br /> �r / <br /> GROUNDWATER WELLS AT <br /> Lf l �' 0 <br /> Client <br /> Site Name 4 <br /> Street Address <br /> '�— <br /> City, State <br /> added equip any other <br /> rinse water 1 a�� adjustments/ <br /> THE NON-HAZARDOUS PURGE- WATER WHICH HAS BEEN TOTAL GALS. loaded onto <br /> RECOVERED FROM GROUND- WATER WELLS IS RECOVERED �� BTS vehicle # <br /> COLLECTED BY THE CONTRACTOR, MADE UP INTO <br /> LOADS OF APPROPRIATE SIZE AND HAULED TO BTS event# time date / <br /> signature <br /> REC'D AT time date . <br /> The contractor performing flus work is BLAINE TECH SERVICES, / /--- <br /> INC, 1580 Rogers Ave , San Jose, CA 95112(phone [408] 573-0555) unloaded by <br /> signature ^ <br /> -------------------------------------------------------------- <br />