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USA ~"'ASTE SERVICES COMP~' NIES
<br />GRAHAM ROAD LANDFILl~.rLLSBORO LANDFILL, N. WASCO COUNTYUINl. ",L, RNERBEND LANDFfLL
<br />WASTE DISPOSAL AGREEMENT
<br />REQUEST FOR SERVICES, TERMS AND CONDITIONS
<br />~ DESCRIBE WASTE TYPE: ~Q..~" a `9`~^~ ~ ° N~ti-~"'~ ` N ~.~'i' d' S ti ~ ` ! ~~, ~'" ~ S
<br />~ DESCRIBE HOW WASTE WAS GENERATED: L..~~...K ~ N~, ~ S %~s'
<br />~ WHAT PERSON OR ENTITY OWNS OR CONTROLS THE WASTE? M~.Y ~ o N ~- ~ c.~ r' c`~
<br />~ WHO CAN WE CONTACT ABOUT THE WASTE? (name/company/full address/voice/fax) To r-. ~ c. ~ a~. ~ ~
<br />i o _ .-~ _ ___ ~,.~ ~ ~ -f' f ~v~ -,., ~.e.. ~- ~ r.r a •. $'~S" ~v ~ r~'lL•t I ~N J Y-~0.L~ , S c.~; ~i y.Z.S-,
<br />V WHERE WAS THE WASTE GENERATED? (site name/address/city/state/county) S~. N~'f'o r 8jo ~ l~- ~
<br />a, o o.~~~.. 5-f- N E S~1 a..~-,,.~ mc~r ~v N o c.._ ~-., _ C~
<br />V QUANTITY OF WASTE? (both estimated weight and volume) ! 3 0 o CY
<br />V DOES THE WASTE PRODUCE ANY ODOR? PLEASE DESCRIBE: No~" K NJ~^- a-~`' Z`"l`%`j -~i r''~Q-
<br />~ DESCRIBE THE FRE(IUENCY OF TRANSPORT TO THE SITE (One Time, On-Going) D~l i~AY ~+ ~'a }~-s. 5~.~ ~~ Z d-U ~
<br />~ IS THE WASTE CONSIDERE HAZARDOUS/ ANGEROUS/TOXIC BY FEDERAL, STATE OR LOCAL REGULATIONS? l-~-a.Z- -
<br />S-~t< FL i~-o`.~.1..v~-.t. riy- _
<br />~ WHO WILL TRANSPORT THE WASTE TO LANDFILL? (name, company, phone, fax) ~O SS ~,vv . r~ NY--~.e.r'
<br />V TRANSPORT VIA: roll-off box ~ dump truck / end dump drums _pickup / trailer
<br />_V PAYMENT INFORMATION: Z~LANDFILL ACCOUNT CASH BUSINESS CHECK VISA/MASTERCARD
<br />For landfill Account Pro ide The Foifowing: Accou~t # P.O. #
<br />~ pj~,AS R..., Y~--o v-: ~+L "- ZS CS' ~:`'\..-i~+ ~ c~
<br />DESIGNATE THE LANDFILL WHERE WASTE WILL BE DISPOSED: (CIRCLE ONE) '
<br />GRAHAM ROAD LANDFILL, HILLSBORO LANDFILL, WASCO LANDFILL, IVERBEND LANDFILL
<br />ALL SECTIONS OF THIS APPLICATION MUST BE COMPLETED - UPON REVIEW A PERMIT WILL BE FAXED TO YOU
<br />APPROVAL INFORMATION
<br />FAX COMPLETED FORM, AS SIGNED ON SECOND PAGE, IABORATORY RESULTS AND CHAIN OF CUSTODY
<br />TO CHRIS THOMAS AT: OREGON (503) 648-2490 WASHINGTON (800) 583-5263
<br />FOR INFORMATION ON CHARACTERIZING YOUR WASTE CONTACT CHRIS THOMAS AT:
<br />OREGON -(503) 844-9597 WASHINGTON -(800) 685-8001 OR E-MAIL: cthomas~spiretech.com
<br />TERMS AND CONDITIONS OF DISPOSAL
<br />1. ACCEPTABLE WASTE. Customer shall deliver and Company shall accept for disposal only Acceptable Waste. Acceptable
<br />Waste means and includes only such waste as is described abov~e and which is approv~ed and permitted for disposal at the
<br />Designated Landfill and shall not include any F~aGuded Waste. As used herein, F~acluded Waste means waste that: (a) is not in
<br />conformance with the description of the waste set fo~th abov~e; (b) is or contains any infectious waste, or radioactiv~e, wlatile,
<br />corcos'iv~e, highly flammable, e~los'nre, biomedical, biohazardous material or hazardous, dangerous, or to~ac substances, as
<br />defi~ed pursuant to or listed or regulated under applicable federal, state or local law above regulated lev~els permitted for disposal
<br />as the Designated Landfill; (c) is prohibited from being receiv~ed or disposed of at the Designated Landfill by federal, state or local
<br />law, ~egulation, nale, code, ordinance, order, permit or permit condition; (d) Company reasonably believ~es would, as a result of or
<br />upon disposal, be a violation of local, state or federal law, regulation or ordinance, including land use restrictions or conditions
<br />applicable to the Designated Landfill; or (e) in Companys opinion would present a significant risk to human health or the
<br />environment, cause a nuisance or otherwise create or expose Company or Customer to potential liability.
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