Laserfiche WebLink
. 08-13-'18 16:09 FROM- T-229 P0003/0003 F-555 <br /> . 10.'31')201$ R07 13! 15 WAX a002/002 <br /> 11835 WIMT;ROCK ROA)) <br /> :•� St4rkyele KANLNO CORDOVA,CA 95742 u1T°°f�`a� Novemberr22 2016 <br /> (91 351-0980 <br /> fagrippJ;"d: <br /> in <br /> 'ltrncr RticipmW; - <br /> EWE <br /> CONDTTIONALIUY LXEMPI SMALL QUAN'rl'1'V GCN..tATORR�SETLT D <br /> CSECK-IN RECL1rl'AND CERT-MCATIO.N STATEMENT N N V 0 2 2016 <br /> TO BE COMPLETED BY CE. -KCRA('OR_ <br /> r certify that rhe")Owing infi 160n is correct,attd J havc road and wdr tmd the roquirtaslonts ror T Thi <br /> Stnticycto CondAiowmity Pxrmpt SnW]l Quhatily GGtarator Waste Acceptance pmgrartL If,,d V 0,w ify that 1 am—aZ`o w1 <br /> Small Qoaudty Gmerator as do5o0dTry pedeml and CCGfOfaia Siatc rc Ihfi . andthis t a ti fpr <br /> Ilmusrot the g" r)"., ti gmitsoreooea-aoti:xcualnotacceptod <br /> qpm'I as a being plcto 0 h If waste is aster fwtid to exceed amhll qu5atiq limits or cnlrtain materipl�not eCCeptcd <br /> under 1hiq vrggram,1 agtae W oompleto R 1l0aardo0e waste rtlaniiw(amt comply with etlla atam rcgWariono as appfvprinta <br /> COMPANY NAMB: ar Servi a COMPANV RET: Jason Steel <br /> COMIMNV AODRF.SB; 4076 E_ Main Street KFAIDs: CAL 000260152 <br /> C,T"•$TAM 7IP: Stor�cton M,9&25215 s1eNwT)rnE: <br /> COMPANY CHONe: (209) 464,1431 . . ._ _._. . TIT]Lru OATIt: <br /> TORE COMPLETED BV STMUYU..E LACK-IN X"F.NWANT <br /> G10dmtA1,NA.47E DESCADrItON 14A%wal) AA STATE <br /> ASS Si 94N rrntrnnJcx Asrl: <br /> CAL C I k1' LrIC. . W - COLU L 40)' SP rhbT <br /> ( � StiA/EB g rrr anrrR <br /> al 1519 <br /> rocessin Fee <br /> 2a- . <br /> METROD OP PAYMENT: CA61-2 D QHF.C"L CHECK NO._ UISO TOTAL PAID E 39.50 <br /> J'1'fl-K►CYCI.ECHECK•TNATTF.NpAN'!SINITIALS l—/ DAM !L <br /> Or4.9T kNV W/if <br /> CHECK-IN RLrCL•IY'r <br />