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ALTA EWRONMENt AL SERVICES, INC. <br /> 831 <br /> 1�Davis SL <br /> - - <br /> Vacavft CA GW7 - <br /> r <br /> `SW)sPlanMaPr�ntatYfMrrirl_+ ,,,a�7%t 4t �:1 b ► <br /> iwty Rin aL r i nedloP "osrda II <br /> 'P NON-HAZARDOUS 1 G@rI rc tor'sfiUS�Pt ID No Manifest 2 Page 1 I <br /> SSA APP f n G c r�l e Document No of <br /> WASTE MANIFEST <br /> 3 1�t�e�leral.ca Va Lech d 5 l Iii�$Address 164 9 E Channell St <br /> !1 <br /> L_,�„ 173`5103 Stockton (sok 95?01 Stockton , Ca <br /> 2 <br /> d Generator s Phone( 09 4bb-3604� <br /> 5 Tran jter 1 an Name 6 U EPAID Number <br /> # °ct�_ W1°Y' y{ rL.I� 1- irlcl �d 7 A (408 ) 927-93 ' 1 <br /> 7 Tior,sporter 2 Company Name B US EPA M Number <br /> 9! Ue^=mn4lad JanLTy6 rrl fa'r ndlSsfe'Ado1r � 10 US EPA ID Number A Transporters Phone <br /> l 11 1 <br /> 1 r rf r3 y I<(,o d IJ y A <br /> 4 B Transporter's Phone <br /> Ca <br /> 1� T ��!! II C Facilltx'sMr) .4 6 1 '3 2''6 <br /> - - 12 Containers 13 jUnif <br /> 11 Waste Shipping Name and Description Tolal No Ty a QUanti <br /> at, hycji-c)carbon -impacted _of I , ACCEPT U 01 1 5 18 ydr. <br /> t - <br /> WFJQHIIIASTER CERTIFICATE <br /> THIS t5 TO CERTIFY ltsal Itse loklowng described commodity was weighed measurscL or cdxried by a wergtmaslar whose aipnNUie Is on this cer111ca1a ratio Is e rorognlzed aulhorNy of acctsrecy as pnscnbad by <br /> Chapter 7(comrnencing with Sedlon 1270D)of Division 5 of the Caklornis Business and Professions Code administered by the Division at liMasuramwit Standards d the California DWartment at Food and Agriculture <br /> We 1.l l i,iii, t rl , r !('KE r NO. s 76711 <br /> fr, 1 I "I'lity. fievi' 1.f7[)htent Cc,. DOT[— D C. 1, 1993 <br /> Welyl (1 I!1 ,, „:�„ Ilay rR(J. Vacaville, Ca. Com111[ din y :l:- SslIL <br /> i1C"4 ss; I1 3tj ", / � h� � i— t I1 Cs/l)ll] t : <br /> iul I 11111{I, 01 <br /> liet_i 1 Total Charge : <br /> l endered : $0. ulo <br /> t)f i4t1 ! 1 , . 9 sf+f;. L(Il,�tl ttri <br /> Ch an e blb. 00 <br /> %Be:C- '1 (hl) H - tyllt i_tJL,. <br /> c''i3l410 I`'aI tf Litz 11j111, L 1.35 � <br /> 4ci1)EIZt NL- t Ut : rvii Lb S)FAlSf) r r1AL-[._ rj <br /> 1 <br /> Y y c e 7 l DEPUTY WEIGIIMASTER <br /> 16 GENERATORS CERTIFICATION I certify the materials described above an If- manifest are not ruble to ted I regulations for reporting proper disposal 04 Hazardous Waste <br /> Printed/Typed Name Signature — Month Day Year <br /> rrDr NITS t,51 Lpa�lllg 1 02J93 <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> NA Signature <br /> Month Day/ Year <br /> Printed/Typed Name g ~� f/J <br /> S <br /> IP 18 Transporter 2 Acknowledgement of Receipt of Matenols <br /> R __` — <br /> T Prnnled/Typed Name Signbture Manrh Day Years <br /> E i <br /> R <br /> 19 Drs[repancy Indication Space <br /> F <br /> A <br /> C <br /> L 20 Facility Owner or Operator Certification of receipt of waste materials covered by is manifest except as noted in[tern 19 <br /> 1 <br /> T <br /> yped No h Day <br /> / nta r_ <br /> a -2p 'n <br /> � r� <br /> man <br /> ! <br /> I�.I",E' TRANSPORTER #1 <br />