Laserfiche WebLink
PACIFIC REGIONAL LANDFILL <br /> AN ALLIED WASTE COMPANY <br /> Client: 77777.2777 Landfill: <br /> ura <br /> Contact: Generator: c a <br /> Phone#: Sales Person: <br /> Quantity: Site: <br /> Reviewed By: 3 _ Address: <br /> Waste Profile Form ;�-Accept Job# <br /> Chain of Custody 2Accept Approval#: <br /> ❑ Gasoline Contamination ❑ Ash <br /> TPH-g ❑ Accept TTLC CAM 17 Metals 0 Accept <br /> BTEX ❑ Accept pH 0 Accept <br /> TTLC Pb ❑ Accept <br /> 0 Diesel/Virgin Oil Contamination ❑ Hydraulic Fluid <br /> TPHd ❑ Accept TPH-hf ❑ Accept <br /> BTEX ❑ Accept BTEX 0 Accept <br /> TTLC CAM 5 Metals 0 Accept <br /> 0 Waste Oil Contamination ❑ Sludge <br /> TPH-g 0 Accept TTLC CAM 17 Metals 0 Accept <br /> TPH-d ❑ Accept VOCs 0 Accept <br /> TOG ❑ Accept SVOCs ❑ Accept <br /> VOCs ❑ Accept Paint Filter 0 Accept <br /> SVOCs ❑ Accept TPH 0 Accept <br /> TTLC CAM 5 Metals ❑ Accept Reactivity, pH 0 Accept <br /> PCBs 0 Acce t <br /> 0 Other 0 Treated Wood <br /> ORGANICS TTLC/TCLP PPM Metals TTLC/STLC PPM <br /> TPH Gas Antimony I Mercury 1, <br /> TPH Diesel !0 Arsenic I Molybdenum <br /> TPH Motor Oil Q Barium %y p Nickel <br /> Other: Beryllium Selenium <br /> Benzene NJ9 Cadmium c Silver Al <br /> Total T.E.X. Chromium Thallium IVP <br /> Total HVOC's ZEChromium 6 Vanadium 2-7 <br /> Total SemiVoc's < Cobalt 7 Zinc a q <br /> Other: Go er <br /> Lead (� <br /> NOTES: Q O — u <br /> 14 <br /> Carr PProva DATE: 9 Q� <br /> DISPOSAL: CLASS II ❑ SOIL <br /> PRE-LIEN YESNO Check w/Management <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 />