Laserfiche WebLink
?, <br />Twin Envifo Services Profile # <br />Milner Landfill (Twin Landfill Corporation) • P.O. Box 774362. 1 4 Avenue <br />Steamboat Springs, Colorado 80477 • voice 9701875-0355 x 8151377-24 office@twinenviro.com <br />Phantom Landfiil (rwin Landfill Corporation of Fremont Counfy)` - remont County Road 67 <br />Penrose, Colorado 81240 • voice 7191372-6671 • fax 8151377-2495 • phantom@twinenviro.com <br />Trinidad (Twin Landfill Corporation of Fremont County) P.O.. Box 267, Trinidad, Colorado 81082 <br />voice 7191846-4030 • fax 8151377-2495 - tdnidad@twinenviro.com <br />Disposal Site Destination (check one) Milner Phantom Other rev o2ms <br />WASTE PROFILE FORM <br />In order for Twin to decide whether we can lawfully and safely accept your waste for dernrery, we must obtain the following information about your waste. <br />The form should be Med out completely by someone ImaMedgeabie about the waste and hazardous waste rules. The Generator makes a hazardous waste <br />determination and is responsible for its waste from cradle to grave. All related analysis must be included with this form, and if future analysis differs from <br />what was submitted, the analytical results must be sent to Twin immediately. AA information on this form must be typed or printed in black ink. <br />1. Generator Information (NOT Consultant, Contractor or Abatement Firm) <br />1. Generator Name: T ?d1?is???t re coal C4 n ?> <br />2. Address: 2 -l 5"1 C- RC !L * 2 Z <br />Oak Gi'ea . C-n X0 '46 7 <br />3. Contact: •CSirt aA Phone: --7 d - 2-7,5`6 <br />Fax: S'7Q -- fl?Sb Email: 4 We?7?lr??' i}p,di Arlyfe er Y, C6 <br />4. Location of Waste Generation: 1jJj3 c, r'9 LIA- <br />4k 6121210C <br />zzl <br />il. Waste Information <br />1. Common Name of Waste: QA( r SdjWtg- C&2 I L ne r ca ?! W CMG I C4 V;P7 <br />2. Detailed Description of Process Generating Waste e) d <br />en 1Lr t1 .yi,-:&d l.S Where- !C2 flea w caa os m u wa . c Ai i? -e- <br />3. Is This a Hazardous Waste as Defined by Federal, State or Local Laws or Regulatioris? [ ] Yes [jj No <br />11111. Physical Characteristics of Waste <br />1. Color: <br />I _. <br />2. Odor: [ None } Miid-. _..[. ] Strong -. --Describe- <br />3. Physical State: [ J Solid ,K Seib 1-Solid(sludge) [ J Liquid [ j Other <br />4. Percent Solids (if known): % <br />5. Waste will be delivered to the site in: [4Bulk [ ] Drum [ ] Other <br />6. Anticipated Volume: Un ICa $14-U?j [ ] Tons [ ] Yards [ ] Drums [ ] Gallons [ ] Other <br />7. Frequency: [ ] One-time [ ] Weekly [ ] Monthly [ ] Other AS &ete P <br />IV. Consultant or Abatement Firm information <br />1. Consultant/Abatement Firm: n v?? dy-elheed &a . c f/Ur Ara,-- <br />2. Address: <br />3. Contact: _ig(Ad .?(t tiiPr Phone: 321s` ° Fax: Email: <br />V. Laboratory Information <br />1. Laboratory Name: <br />2. Contact: Phone: Fax: Email: