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Pu'uanahulu Landfill Sampling Form <br />Sample ID: Load Type <br />Date: <br />Generator: <br />Vehicle Type <br />Cardboard <br />Newspaper <br />White Ledger <br />w Colored Ledger <br />a- Computer <br />a <br />a- Office <br />Magazines <br />Directories <br />Miscellaneous <br />R/C Paper <br />Clear Containers <br />U) <br />Green Containers <br />U) Brown Containers <br />J Other Containers <br />(7 <br />Flat Glass <br />R/C Glass <br />Aluminum Cans <br />Tin Cans <br />J <br />< Ferrous <br />w Nonferrous <br />White Goods <br />R/C Metal <br />U <br />Li <br />(Commercial Loads Only) <br />TS <br />Corn <br />Hauler: <br />Route: <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ (TS Boxes Only) <br />Res <br />Corn <br />Mix <br />Const <br />GW <br />R/C <br />Site/Origin: <br />❑ <br />❑ <br />❑ <br />❑ <br />Packer <br />Roll <br />Other <br />TS <br />Off <br />Corn <br />Box <br />Food <br />Textiles <br />U Leaves and Grass <br />aPrunings <br />Stumps <br />O Crop Residue <br />Manure <br />R/C C)rnanir. <br />#1 Containers <br />U #2 Containers <br />Other Containers <br />Film <br />a- Durable <br />R/C Plastic <br />Concrete <br />Asphalt Paving <br />Asphalt Roofing <br />Clean Lumber <br />U Treated Lumber <br />Gypsum Board <br />Rocks and Soil <br />R/C Demo <br />Paint <br />Ash Vehicle Fluids <br />Oil <br />Sewage Sludge = <br />Batteries <br />a Industrial Sludge <br />w Treated Medical R/C Hazardous <br />Cn Bulky Items <br />Tires <br />R/C Special Evidence of Explosive /Hard -to- Process Items in Load: <br />Mixed Residue Yes ❑' No ❑ <br />Explosives: <br />(e.g., propane tanks) <br />Hard -to- Process Items: <br />APPX B WASTE COMPOSITION REPORT 121709.DOC E -3 <br />