Laserfiche WebLink
® f este 1U1e1' OCU ' ent Daily Field Ticket No. 1" - <br /> a _ y 45433 <br /> GENERATOR:; <br /> DESIGNATED TSD FACILITY ALTERNATE TDS FACILITY <br /> Name: —T <br /> Name: Name: <br /> EPA# EPA# = <br /> EPA# <br /> f <br /> Address:' Address: J � C7 Address: <br /> Order Placed: Order Date: <br /> WASTE ❑ - DRILLING MUD ❑ - GASWELL WATER -OTHERS <br /> Wei ht/Volume 1 0/9 <br /> 9 Units Container: ❑ - Dump Truck ink Truck <br /> This material is nonhazardous because: <br /> 1)it is a drilling mud containing only the additives listed byjt a Department in its exemption <br /> letter and contains no significant concentrations of toxic m'terials from natural sources,or <br /> 2)is a sulfur-dioxide scrubber solution from.a sodium hydroxise or sodium carbonate oil <br /> field boiler scrubber system, and possesses no characteristics that would require its SIGNATURE OF AGENT <br /> handling as a hazardous waste. AUTHORIZED DATE <br /> TRANSPORTERl t <br /> lIr <br /> Warren.E. Gomes Exc., Inc. Job N0.4AD(-I�t/1r��°f"Y 7,V1�J "�f 7MNATUREOFBUYER <br /> P. O. Box 369 �,� M..Rio Vista, CA 94571 Unit No.(707) 374-2881 <br /> EPA#CAD076557370 <br /> TSD FACILITY _ Method of Disposal: <br /> Name 1-' 0 - Injection Well <br /> QTY Measured L� ❑ - Landfill <br /> ❑ - Land Treatment <br /> EPA# ❑ - BBL ❑ - TONS ❑ -,OTHER ❑ -_Surface Im rxi nt <br /> ' - Other <br /> 511INATURE OF AUTH(k9lZED ENT DATE " <br /> TSDF TO GENERATOR <br />