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a _ <br /> NOIR-HAZARDOUS WATER TRANSPORT FORM <br /> �• GENERATOR CUSTOMER <br /> Name: _._SJ County Courthouse Name: Rama e Envrronmental, Inc. <br /> Address: 222 E. Weber Avenue Address: ! 465:S. Me ows Pkwv,, Ste, 20 <br /> Stockton CA Reno NY <br /> 89521 <br /> Phone: (775) 851-7240 Phone: i 775-$ -7239 <br /> DESCRIPTION <br /> Description of Water : Pur e water from Monitoring Wells ; <br /> Volume/Weight: Units: gallons Container(s): Poly Tank <br /> This non-hazardous waste water is monitoring well purge water,auger rinsate,sampling equipment rinsate,tank <br /> rinsate,combination thereof,or as described above. Described water may coritain dissolved hydrocarbons. I certify that <br /> the above named material has been properly described and classified according to applicable regulations,and possesses <br /> no characteristics hat would require its handling as hazardous waste, <br /> i <br /> Generator/Authorized Agent: Hal Hansen <br /> Print Sign, Date <br /> TRANSPORTER <br /> Name: Doulos Environmental Job No: NA <br /> Address: P. O. Box 2559 Pick-up Date: 7 r2 Z <br /> Orangevale, CA 95662 Truck ID: i NA Ij <br /> Phone: 916-990-0333 Driver: 4)g'' '7-14-67 <br /> Sign', Date <br /> DISPOSAL FACILITY <br /> Name: InStrat Inc. Quantity: <br /> Address: P. O. Box 2279 Units: :! gall6ns <br /> Davis CA Disposal Method: if- <br /> Received.by: �t <br /> Print Sign Date <br /> i� <br />