Laserfiche WebLink
' 6. NON-HAZARI)OUS I11A I ERLALS HAULLNG AIANTFEST <br /> NAME AsricutsiESF„PRODt1GTS COk�p�NY LOT# <br /> ADDRESS MO I<ruV- W” Ftgce PHONE.NO (0 3S- i ��D <br /> CITY, STATE,ZII` <br /> G CONTAINERS No 10 VOLUME Z 3 WEIGHT <br /> E TYPE' TANK DUMP x DRUMS OARTONS OTHER <br /> N WASTE DESCRIPTION 5 0 ' 1 GENER�kTING PROCESS U S T <br /> E COMPONENTS OF WASTB PPM COMPONENTS OF WASTE PPA4 <br />' R D;cscl 3400 <br /> A ' lo�aY of 14 -�O <br /> T <br /> PROPERTIES pH- SOLID- X LIQUID S4URRY OTHER_ <br /> HANDLING INSTRUCTIONS -rqrp L, o A J <br /> GENERATOR CERTIFIES THIS WASTE AS DESCRIBED IS 16% NON-HAZARDOUS <br /> BY ULW A 6o4r Dot we66�aVer- (AFPC) DATE $ Is- <br /> PRINT <br /> OR TYPE FULL NAME <br />' COMPAN-'NAME a 6 Iru e k, In \ - p <br /> Hg T l � SHONE NO <br />' A ADDRESS- J 7 20_ �+s raH !^_� er'. SERVICE ORDER NO <br /> U CITY, STATE,ZIP. VatGq i-CA -E S 3 7 V WICK UP DATE. ' <br /> L <br />' E TRUCK I D NO TRAILER NO, I 05-Y Iq-- 1;11A 1D NOCA Z q?3 9[f <br /> R DRIVER e, �2&z' DATE. S j <br /> SIGNATURE PRINT OR TYPE FULL NAME <br /> }} <br />' PROCESSOR : �— <br /> PORT COSTA MATERIALS, INC DISPOSAL METHOD- THERMAL REMEDIATION <br />' 9000 CAKOUINEZ SCENIC DRIVE <br /> PORT COSTA,CA 94569 PHONE, (415) 643-1200 <br /> IF MOVEI�MNT BY OTHER THAN TRUCK, CALL FOR APPROPRIATE FORM <br /> hiry 1�yI p c m <br />