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El <br />E <br />Subject: HAZAJMUS WARE Category: <br />OMLUMON PROCEDURE SAFETY <br />Effective Date: 3M6M <br />0:41ti' i <br />DATE: <br />TIME: <br />VEHICLE OWNERor COMPANY: <br />TRUCK #: TRUCK LICENSE #: <br />TELEPHONE NO. <br />Please Print Name <br />FREE DRAINING LIQUID OBSERVED: (_) YES (_) NO <br />IF ANSWER IS YES, NOTE THE FOLLOWING OBSERVATION INFO: <br />(d) suspected source and comments: <br />LANDFILL SUPERVISOR'S SIGNATURE: <br />