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PACIFIC REGIONAL LANDFILL <br /> AN ALLIED WASTE COMPANY <br /> Client: Landfill: a <br /> Contact: a( h Generator: <br /> Phone#: Sales Person: 60 <br /> Quantity: Q2 `t S Site: QQ Q W 7 <br /> Reviewed By: J G-, Address: - O <br /> Waste Profile Form O-Accept Job# <br /> Chain of Custody 2mccept Approval#: <br /> e�Gasoline Contamination ❑ Ash <br /> TPH-g tPAccept TTLC CAM 17 Metals ❑ Accept <br /> BTEX 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 0 Accept BTEX ❑ Accept <br /> TTLC CAM 5 Metals C Accept <br /> Waste Oil Contamination 0 Sludge <br /> TPH-g ❑ Accept TTLC CAM 17 Metals 0 Accept <br /> TPH-d ❑ Accept VOCs ❑ Accept <br /> TOG ❑ Accept SVOCs ❑ Accept <br /> VOCs ❑ Accept Paint Filter ❑ Accept <br /> SVOCs 0 Accept TPH ❑ Accept <br /> TTLC CAM 5 Metals ❑ Accept Reactivity, pH ❑ Accept <br /> PCBs 0 Accept <br /> Other ❑ Treated Wood <br /> ORGANICS TTLC/TCLP PPM Metals TTLC/STLC PPM <br /> TPH Gas 30 Antimony Mercury <br /> TPH Diesel Arsenic Molybdenum <br /> TPH Motor Oil Barium Nickel <br /> Other: Beryllium Selenium <br /> Benzene 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 /> NOTES: Lead <br /> Gac P DATE: 7 Q <br /> DISPOSAL:JCLASS II 0 SOIL <br /> PRE-LIEN YES 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 />