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o <br /> NON-HAZARDOUS Ste Hauler Document Daily Field Ticket No. <br /> 44888 <br /> GENERATOR DESIGNATED TSD FACILITY ALTERNATE TDS FACILITY <br /> Name: Name. - g Lr Name: <br /> EPA# EPA# EPA# <br /> Address: Address: I Address: <br /> Order Placed: Order Date: <br /> ',WASTE ❑ - DRILLING MUD ❑ - GASWELL OTHER c-m .•- <br /> WeightlVolume Units Container: ❑ - Dump Truck .-Y-Tank Truck <br /> This material is nonhazardous because: <br /> 1)it is a drilling mud containing only the additives listed by the Department in its exemption <br /> letter and contains no significant concentrations of toxic materials from natural sources,or <br /> 2)is a sulfur-dioxide scrubber solution froma sodium hydroxise or sodium carbonate oil <br /> field boiler scrubber system, and possesses no characteristics that would require its SIGNATURE OF AUTHORIZED AGENT DATE <br /> handling as a hazardous waste. <br /> TRANSPORTER ,.p.. <br /> Warren E. Gomes Exc., Inc. Job No, 6 r cm st / � Pick-U Date 0a <br /> P. O. Box 369 <br /> Rio Vista, CA 94571 Unit No. <br /> (707) 374-2881 slcN RE OF BUYER <br /> EPA#CAD076557370 <br /> TSD FACILITY Method of Disposal: <br /> i o - Injection Well <br /> Name QTY Measured o - Landfill <br /> o - Land Treatment <br /> EPA# h ❑ v BBL ❑ - TONS ❑ - OTHER ❑ -.Surface Impoundment <br /> 'o - Other <br /> SIGNATUR�EQF AUTHORIZED AGENT DATE <br /> TSDF TO GENE,RATOR <br />