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Nand, L4 95341 Sus"10, CA 94089 futin" A 42029 Santa Atw, CA 92707 <br />� � 265 Riggs Avanut 1210 Uko Drive 22ISNryeRAvaaa 2501 S. Dacey Si.,Suites <br />209 722-4728 v 408 548-5050 P 750 489 5600 P 714 545 2191 P <br />nme..ea..«.., m.,.a..209 722 8228 t 408 548.5052 t 760 4895625 i 714 5453787 x <br />workOmara <br />Propria x <br />Dote <br />amount smog Mann or <br />Custorrter InformationService <br />Name. (MLC LLC dba trwlley T g I'nxtucta <br />AddmSs. 1313 Smell Ste±;ton Strom <br />Lodi, c1A952A0 <br />FPA In 10 CAL OIp4 393 274? <br />Main Contact: Ctwiy Meyer <br />Phone: X09.2160-2834 <br />Secondary Contact: <br />Prtiaxx. <br />Request <br />Description: <br />'xork r ;t if or o 3154 _.. <br />-i'idW20-DEC-]d <br />�dI# <br />.. ._ ._.._, f.p._�......__._ <br />1 TT - Vacuum Turk,, W;I to — I1)967Ui A <br />Labor Tanker Drive - <br />----- <br />�-- <br />F9taf protestive ErP t rnt -Leval D <br />.� _. __,... <br />i - Fuel ai EttrsLav )tevrnrrs?r i'Pee - i 'R,,NOR .._ -_ _._ ..._. <br />Manifest ani! t3et5erettfr <br />rmatfon <br />Pass <br />Fsll Pass ail I Retain ID <br />- __ <br />Container infamution <br />Chlor D -tett <br />pN <br />-__ <br />Containers <br />I No. ryas <br />Total <br />RuenOil, <br />vvwsnwolu,m, <br />US DDT Description (Include proshipping mama, Naz class and ID) <br />x::�4�?'?32:iiT,'i lt3%t. ',.�31.•".'. Llq"!" <br />i7t <br />TT <br />G <br />Manifest Number 37 i 4-4 Transporter ID No i,Ap ( 070 540 �neine <br />ntnr EPA in Nn <br />CAL 060 3dE <br />ji <br />Designated Facility and address P1.iLa271at5. i..atN:it-1 it kt:e:vim: F3ahty <br />e alt'_v G7+]li:. # (921) 455-7301 i <br />t t 10 pskar. u:e:t Piss Ro, 9 <br />QUA LPAID0 =^,AD 981 382 732 <br />stereos <br />Disposal Services: <br />Transportation Services, <br />Manifest Number .Site. praiile.F <br />9Tv TSDF <br />Numberor Cordainers Faeahy/Deadnatlon <br />NOW ReerondWed <br />CYJanaY Mu:a. aaPPty Descripaun <br />Supplies <br />Metwi PDIY Fber Meta PolyonFiber <br />55 allon closed top <br />... ..._ <br />55 -gallon open top <br />30 -gallon closed top <br />30 -gallon open top <br />15 -gallon closed top <br />15 -gallon open top <br />Labor: HourstRa Slat Nours(Ovadima Service Provided <br />5- gallon closed top <br />Project Manger <br />Chemist .. _. _.. <br />iachniden <br />other. <br />5- gallun open top <br />275gallon tote <br />Nates: <br />Cubic Yard Box <br />_. _. .._..._.. _.. <br />4h Light Tube Drum <br />Customer Signature: <br />Date: -•) <br />art Light Tube Drum <br />Vermiculite, Bag <br />Clay Absorbent, Bag <br />PPE <br />