Laserfiche WebLink
PACIFIC REGIONAL LANDFILL <br /> AN ALLIED WASTE COMPANY <br /> Client: 771, 77VI Landfill: F7 r W.177 <br /> Contact: Generator: ,Q ca" <br /> Phone#: Sales Person: 3 <br /> Quantity: 4 C 'Irs' Site: V 7� 9 1A <br /> Reviewed By: j Address: c-" s <br /> Waste Profile Form a-Accept Job# <br /> Chain of Custody ccept Approval#: <br /> 0 Gasoline Contamination ❑ Ash <br /> TPH-g 0 Accept TTLC CAM 17 Metals ❑ Accept <br /> BTEX 0 Accept pH ❑ Accept <br /> TTLC Pb 0 Accept <br /> ❑ DieselNirgin Oil Contamination 0 Hydraulic Fluid <br /> TPHd 0 Accept TPH-hf 0 Accept <br /> BTEX 0 Accept BTEX 0 Accept <br /> TTLC CAM 5 Metals 0 Accept <br /> 0 Waste Oil Contamination ❑ Sludge <br /> TPH-g ❑ Accept TTLC CAM 17 Metals 0 Accept <br /> TPH-d ❑ Accept VOCs ❑ Accept <br /> TOG 0 Accept SVOCs 0 Accept <br /> VOCs 0 Accept Paint Filter 0 Accept <br /> SVOCs 0 Accept TPH 0 Accept <br /> TTLC CAM 5 Metals ❑ Acce t Reactivity, pH 0 Accept <br /> PCBs 0 Accept <br /> ❑ Other 0 Treated Wood <br /> ORGANICS TTLC/TCLP PPM Metals TTLC/STLC PPM <br /> TPH Gas Antimony Mercury <br /> TPH Diesel 93 Arsenic Molybdenum <br /> TPH Motor Oil / q Barium Nickel <br /> Other: Beryllium Selenium <br /> Benzene A10Cadmium Silver <br /> Total T.E.X. Np Chromium Thallium <br /> Total HVOC's p Chromium 6 Vanadium <br /> Total SemiVoc's Cobalt Zinc <br /> Other: Copper <br /> Lead <br /> NOTES: <br /> 4rP��a� Va DATE: l7 <br /> DISPOSAL: ❑ CLASS II SOIL <br /> PRE-LIEN YES NO 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 />