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ALTA ENVIRONMENTAL.SERVICES,IMC r <br /> Vacaville, CA 95687 s p <br /> is r` s„ 'r�"AA rte' i [8013 794-2768 <br />�4+�Pledie print M '?a i°.r a jsl t�+1'S1 f'a�s#a r <br /> b,r,� aryn dear nett lll��ettt us!on et(te �rz Ch - <br /> I�f NON-HAZARDOUS I Generator s US EPA ID No Manifest 2 Pogo 1 k <br /> 1 N o t A ri r l I -i b 1 e Document No of <br /> WASTE MANIFEST <br /> n i <br /> 3 G, er for s Na a and MPdm Address <br /> t^7 7 `�,t 1 `�eas7n,y 1649 E Channell St <br /> f,c„ -. 5 ) 03 , Stockton , Ca 95 _0 Stockton , Ca i <br /> ' 4 G,nEralor s Phone( `' 9 465-3609 <br /> r <br /> 5 Tran garter 1 Cqmoany,Name 6 US EPA ID Number <br /> I L.f` 1 " 1 rLI011)C,1 rd . (4 08 ) 927--321 <br /> 7 Trunsporter 2 Company Name 8 US EPA ID Number <br /> 1 <br /> 9 Destgnoted Facility Na q an Srte Address 1p US EPA ID Number A Transporter's Phone <br /> L i d I L �i n dt 1 IV, ] n c B Transporter's Phone <br /> forty , 14 / R <br /> � d C Facility's Phone � <br /> (707 ) 451-3_76 <br /> 1 I Waste Shipping Name and Description 12 Contomeri 13 14 <br /> Total Unit <br /> No Type Quantity Wt Vol <br /> 94,,t rcl jus hydrocarbon 1fnpaCted ACC EPT 4; 0 1 It 5 18 yos <br /> WEJGHUASTER CERTIFICATE <br /> HIS IS TO(,LRTIFY ttrat the tollowing described cartxrrodty wa7 svelgtrad measured,or counted by a weifltvnasler wtroae sipnature Is on the conOwale who k a lmd authority d accuragr ss prescnbed by <br /> ho0or 7{commencing wdh Section 12700)of Derision 5 0l the Calrfornla Busnew and Prolowic ria Cale adrninetered by Ihe�is iston or Meawaurarnant Standards of the Cepomla DeparlmenI of Food end Agriculture <br /> r <br /> rTfjliiil tc=r IILKET 1\10. 76715 <br /> 1 ! t ,r{1 'r tif14Jt31 GptneflL Lv. DA I L: DLC 17 1993 t) :Ja: 1`4 <br /> wt.. ItiiIt. C; ii, r-, It Clay riff. VaravjIIe, Crr_ l rimntodity : C- anIL <br /> 1111141 ; l ('r l(_ta/Iln :l3= <br /> 1r 01 : <br /> i., I lila t i�lr 1_ J �' <br /> Tender ; b1�. 1jFll1 <br /> V 071 1 { t i , 9`�t�I� / k111c�1[iiFi Change ; 10. 00 <br /> uULI IE <br /> t <br /> lrfil t1r G !,, J Iiitt t_t1S.. <br /> las it- 11, I L}hL t bb. <br /> �t�;4.fa� tJi l llt I t lit l_r,€, "_X ! HALAL <br /> p{�VEFj4J G L <br /> I T1 b 14 i 1 s I . /l+i_a_ 11 {_iC_t. 1 s„ L 5 DttVIT WtiWill,01Abitm <br /> t <br /> lb GENERATOR 5 CERTIFICATION i certdytthe materials described a6ova on this manliest are not sub t to fyder? gulations for reporting proper disposal of Hazardous Waste , Gi <br /> Printed/Typed Name Signature Month pay Year <br /> rlt:fl- t r'.ir Mid Cal L.eaSirlq J <br /> T 17 Transporter I Acknowledgement of Receipt of Materialsr <br /> oe- <br /> APrimed/T d sine ' Signet �' Month tray Y 0, <br /> / k <br /> N N1 <br /> P 18 Transporter 2 Acknowledgement of Receipt of Materials baa 1 <br /> R ---- c <br /> T Printed/Typed Name Signature Month pay Year <br /> E <br /> R " <br /> 19 Discrepancy Indication Space <br /> IF- <br /> A A <br /> C <br /> 20 Fucility Owner or Operator Certification of receipt of waste materials covered by rs manifest except as noted in Item 19 <br /> Y Panted/T <br /> ype Name Signa re Month oy ear <br /> I�i <br /> Rim 1= <br /> r e <br /> "� TRANSPORTER#1 <br />