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ALTA ENVIRONMENTAL SERWESa M i <br /> 8_31 hauls SL <br /> � a , (8W)784-2768 <br /> ��bre �` <br /> i <br /> v NON-HAZARDOUS IN MEN <br /> ' T.oe ttoYA U S 9A ID °� pocumentsNo 2 P°&° 1 <br /> WASTE MANIFEST of <br /> 3.}Y ertt rslNa�na�SMonrn�g Address 1649 E Channc-1 1 St <br /> P ; F,0r 3 5 10 3 _ Stockton , Ca . 9520 Stockton , Ca <br /> 4 Generator's Phone( 209 } Q 5-3609 <br /> Tra s orter 1 C m a Name 6 US EPA ED Number ,� <br /> ` atf r �• r�`ruck�nC IJ 4 ( 408 ) 927 922 <br /> _ 1 <br /> 7 Transporter 2 Company Name 8 US EPA ID Number i <br /> q Desi ngted Fa4hty Na n Site A ress ID US EPA ID Number A Transporter's Phone <br /> 1' ca�r`� , ' n t 1 r f , n C B Transporters Phone <br /> 1 r ij Fit}y d 14 / A C Faah 's Phone <br /> Ca 707) 451-3278 11 <br /> - `Y <br /> �12:ConHiainers 13 141 r Waste Shipping Name and Description Total Unit QuantityWt Vol <br /> 4.n i ridZ_Irdcju., hydrocarbor, -1n%pac.,tad 5,011 ACCEPT . #! 011 E 5 18 ydS <br /> WEIGIM"TER CERTIFICATE <br /> THIS IS TO CERTIFY that the tolowing described cartvttodRy was waighe0 measured or courttrrd by a+waphnauGer Whose ntNre le on Ittls certif>wle t"ha Is e rocognlzed sut�ty d accuracy as presanbed by <br /> Chapter 7(commencing with Sedan 12700)d DMs1on 5 d ilia CaNtornta Birsaneas and Proleurtorts Code administered by the Division of Idleasutentent Standards of the California Department of Food ruts Agriculture <br /> 1,Jta c i[I,inri ai �i _r IC:KCT NO. i 76768 <br /> yr 3 013ML Fit CO. DATE: DEC 1, 1993 1 c ::6 34 <br /> � iyltiri 1a ( �t.sL Hay Nd. VaC -k 3. 11t?, t �,. Conltit odity :C-S©1L ' <br /> F r (1t11�1t J , a! lir ace/Unit : <br /> I I : i Ilii l Ise iVlTl`f 1117i�t1,41t_ <br /> ,I Int L_ I � �� fUtal Ct1a1^ge : <br /> Tendered to- VjV1 <br /> WAS fit` I I t : , 9`,( f� 3 ICIur,,g� Change ; <br /> Liiltl iF 1at1. '� <br /> /61 -0 (Irl) (3t o,, 1.1, illhl. Ll,s. <br /> 71 <br /> r6b0 I�l+_;t WL a 13ht L.bt� MARY �Uf21�EN e <br /> /Q CePDM E 1 1.t'I ! (s I, r_(riL1 3 DEPUTY WQGHMASTFR <br /> 16 GENERATOR'S CERTIFICATION I certify the materiels described above on this manifest are not cabled eral raqulohons for reporting proper disposat of Hazardous Waste <br /> Printed/Typed Name Signature Meath Pay Year , <br /> r ror Mid Cal LeaSing 2 10 I 0,1 <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> RASr natu t Mouth D y Ye r <br /> N Panted/T ame 9 u <br /> S _ <br /> P ' <br /> R q IS Transporter 2 Acknowledgement of Receipt of Materials , <br /> T Premed/Typed Name Signature Month Day Year' <br /> E <br /> R i1 <br /> 19 Discrepanty Indication Space v <br /> F <br /> A <br /> C <br /> 1 — <br /> L 20 Facility Owner or Operator Certification of receipt of waste materials covered bLtmanifest except as noted in Rem 19 <br /> 1 <br /> T <br /> YPrintg� ped Name Stgnat Mont D e r <br /> t <br /> 5 f TRANSPORTER #1 WN <br />