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ALTA©NVtRONMENfAL SERVICES,INC. ' <br /> 831 Dams St --- - - - <br /> ,� �,. <br /> v CA <br /> (' r r 2768 <br /> 7 <br /> ppri <br /> Qe� hail 11as on N a <br /> NON-HAZARDOUS 1 Generators US EPA ID No TDocument 2 Page 1 <br /> WASTE MANIFEST tJr'f '��'�') `" '1 of <br /> QC29 C)h <br /> 11 <br /> 1Ca�pergtor't1LL fraS'10Nalrse and Moiling� Address <br /> x• 1649 E Channell St <br /> ` 1 ll <br /> I) Boa , 55103 Stockton , Ca 952ri W Stockton , Cal <br /> 4 Generator s Phone( 7`)9 ) 465-3609 <br /> 5 Trues orter 1 m Name 6 US EPA ID Number <br /> [ �,ur`ra` `ruck inc N / A ( 408 ) 927--9..rz I <br /> 7 Transporter 2 Company Name B US EPA ID Number <br /> Q Desi ,n,ted;facd,ty Na g all �ite AddressT10 US EPA ID Number A Transporter's Phone <br /> r n ft L d o f I g Transporters Phone <br /> 1 0 ha y RC1 a rs A C Facility's Phone <br /> 11r , Ca ( 707 ) 451-3276 <br /> 12 Containers 13 14 <br /> 1 l Waste Shipping Name and Description Total Unit <br /> No Type Quantity Wt vol <br /> Rf� ri I1c,Zardous h ,,drocarbor, impactedc-) 11 . ACCEPT . 4 0 1 16 5 1 £3 ycl� <br /> i <br /> WE1C OUSTER CERTIFICATE <br /> THIS IS TO CERTIFY that the lo%Owm]dewfibed Commodity was we mossurad,or counted by■we,ptmaider whom signature is on this certricate who la.woprdzed suttsorily at accuracy as proscribed by <br /> Chapter 7(commencing with Section!2746)of DNlseon 5 of the GNarnla Businea and Pratewbrss Code administered by theDHislon ot moi summent Standards al the C idwrols DePartrTso'st d Food and Agriculture <br /> W1* I �l1 „ A 1z( � f T CKCT NO. : 76777 <br /> r► 1 ( ti i,tii y 111 /c lopweitt. ( ty. DfllE : DEC 1 , 1993 , 1L2'(45 Q11.� <br /> Eli�tir ri 1" t I. f 11ay FW Vacavl 1 its, IF-a C:ommodity :C--SOIL <br /> i_ lit `11{i , iC IV�irf iil)Ic! fit <br /> ,1 fi, ,tlli � lFti_I_ i 1 ictal CI-serge : <br /> Tendered a $14, 00 <br /> Change : 4,0. 0 v <br /> 43CI i t ii 0 1 ; I.: <br /> 17LQI <br /> - F _1121500 _ I ti-!: JJ- .1 ibis; L Li 4.. _ <br /> { r d0 IJet. W011411L Lb]. WIRY BORDEN <br /> UIFIYEBtf IGNl1TU DEPUTY tNEIGHMASTER <br /> ME <br /> 16 GENERATOR'S CERTIFICATION I certify she materials described above on this manifest are not d t eral regulations for reporting proper disposal of H000rdous Waste <br /> Profiled/Typed,Name Signature Month Day Year <br /> i,-I r for mid Gal Leasing 112 b 1 13 <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> APrinted/Typ arae Signature M nr Day ya� <br /> N �'« , 7�J <br /> P <br /> p 18 transporter 2 Acknowledgement of Receipt of Materials <br /> T Panted/Typed Name Signature Month Day Year <br /> E <br /> R <br /> 19 Discrepancy indication Space <br /> r <br /> F <br /> A <br /> C <br /> I - <br /> 20 hacolity Owner or Operator Certificat,on of receipt of waste materials covered by this manifest except os noted in Item 19 <br /> T _ <br /> Ty '� S not o t y "+` <br /> -- c' Da Y or <br /> Pro T d e m � <br /> TRANSPORTER#1 <br /> f � , <br />