Laserfiche WebLink
c. <br /> .� -� <br /> ® ase Hauler Document Daily Field Ticket No. 45491 <br /> GENERATOR DESIGNATED TSD FACILITY ALTERNATE TDS FACILITY <br /> Name: Name: P r T Name: <br /> EPA# EPA# EPA# <br /> Address: Address �rl 1 lh � Address: <br /> Order Placed: Order Date: <br /> WASTE ❑ - DRILLING MUD ❑ - GASWELL WATEROTHER PLt <br /> Weight/Volumed Units Container: ❑ -. Dump Truck - 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 /> `efi'or and contains no significant concentrations of toxic materials 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 AUTHORIZED AGENT DATE <br /> handling as a hazardous waste. <br /> e <br /> TRANSPORTERC,�,�� <br /> Warren E. Gomes Exc., Inc. Job No. Pick-Up�te <br /> P. O. Box 369 <br /> Rio Vista, CA 94571 Unit No. <br /> (707) 374-2881 SIG AMJW09 BUYER <br /> 'EPA#CAD076557370 <br /> TSD FACILITY Method of Disposal: <br /> - ❑ - Injection Well <br /> Name x <br /> - - QTY Measured ❑« Landfill <br /> ❑ 4`.,Land Treatment <br /> EPA# ❑- BBL ❑ - TONS ❑ - OTHER ❑ rface 1 o n_ ent <br /> q-- er <br /> SIGNATUil1E FFAUTHORIZE GENT DATE <br /> l f. <br /> TSDF TO GENERATOR <br />