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PACIFIC REGIONAL LANDFILL <br /> 12YAN ALLIED WASTE COMPANY <br /> Client: Landfill: af <br /> Contact: c,11 ,A Ce enerator: �s �� <br /> Phone#: Sales Person: <br /> Quantity: Site: <br /> Reviewed By: Address: <br /> Waste Profile Form wept Job# <br /> Chain of Custodyccept 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 ❑ Accept <br /> 0 Diesel/Virgin Oil Contamination 0 Hydraulic Fluid <br /> TPHd ❑ Accept TPH-hf 0 Accept <br /> BTEX ❑ Accept BTEX ❑ 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 0 Accept SVOCs 0 Accept <br /> VOCs ❑ Accept Paint Filter ❑ Accept <br /> SVOCs 0 Accept TPH ❑ Accept <br /> TTLC CAM 5 Metals 11Accept Reactivity, pH ❑ Accept <br /> PCBs 0 Accept <br /> 0 Other 0 Treated Wood <br /> ORGANICS TTLC/TCLP PPM Metals TTLC/STLC PPM <br /> TPH Gas Antimony Mercury <br /> TPH Diesel 7a Arsenic Molybdenum <br /> TPH Oil Q Barium Nickel <br /> Other: Beryllium Selenium <br /> Benzene Cadmium Silver <br /> Total T.E.X. VVChromium Thallium <br /> Total HVOC's Chromium 6 Vanadium <br /> Total SemiVoc's Cobalt Zinc <br /> Other. E:.s_:k Pes-s-e 2 Copper <br /> NOTES: Lead <br /> Carp. DATE: 7 <br /> DISPOSAL: CLASS 11 D 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 />