Laserfiche WebLink
PACIFIC REGIONAL LANDFILL <br /> AN ALLIED WASTE COMPANY <br /> Client: Landfill: <br /> Contact: cc C A Generator: <br /> Phone#: Q - Sales Person: <br /> Quantity: C Site: <br /> Reviewed By: Address: SQ c <br /> Waste Profile Form Accept Job# <br /> Chain of Custody Accept Approval#: <br /> oline Contamination ❑ Ash <br /> TPH-g Accept TTLC CAM 17 Metals ❑ Accept <br /> BTEX Accept pH ❑ Accept <br /> TTLC Pb Accept <br /> ❑ DieselNirgin Oil Contamination 0 Hydraulic Fluid <br /> TPHd ❑ Accept TPH-hf 0 Accept <br /> BTEX 0 Accept BTEX ❑ Accept <br /> TTLC CAM.5 Metals 0 Accept <br /> 12 Waste Oil Contamination 0 Sludge <br /> TPH-g 0 Accept TTLC CAM 17 Metals ❑ Accept <br /> TPH;g, 0 Accept VOCs 0 Accept <br /> TOO ❑ Accept SVOCs 0 Accept <br /> VOCs 0 Accept Paint Filter ❑ Accept <br /> SVOCs 0 Accept TPH ❑ Accept <br /> TTLC CAM 5 Metals ❑ Accept Reactivit , pH ❑ Accept <br /> PCBs 0 Accept <br /> 0 Other ❑ Treated Wood <br /> ORGANICS TTLC/TCLP PPM Metals TTLC/STLC PPM <br /> TPH Gas n Antimony Mercury <br /> TPH Diesel Arsenic Molybdenum <br /> TPH Motor Oil Barium Nickel <br /> Other: Beryllium Selenium <br /> Benzene Q Cadmium Silver <br /> Total T.E.X. Chromium Thallium <br /> Total HVOC's Chromium 6 Vanadium <br /> Total SemiVoc's Cobalt Zinc <br /> Other: Copper <br /> ]Lead <br /> NOTES: <br /> Ccrf Q DATE: I t <br /> DISPOSAL: LASS II ❑ SOIL <br /> PRE-LIEN YES Check w/Management <br /> P-VL/ 14 ' 'Iqw <br /> 1145 WEST CHARTER WAY, POST OFFICE BOX 6336 <br /> STOCKTON, CA 95206 <br /> 800.204.4242/FAX 209.466.1067 <br /> www.disposal,com <br />