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I <br />' Generator Information <br /> Name Advanced Geo Various Sites C,o ff�fo u <br /> iAddress Various Sites <br /> Description of water:Non-Haz purge water UST Sites <br /> Basis for determination that water is non haz Analytical r <br /> Generator/Authonzed entZj'e4V?11-L- 1- `6 —0 <br /> Print sign date <br /> Transporter Information <br />' Company name- American Valley Waste Oil <br /> Truck Id Driver <br /> Pant sign date <br /> Total Gallons <br /> Facility Information <br /> Cascade General Inc Approval Number 704-052 <br /> 5555 N Channel <br /> Portland, OR 97217 <br /> ORD18761934 <br /> Via Railcar# <br /> EReceived by <br /> Print full name and sign date <br />