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ALTA FaMRONME NTAL SERV#CES,1Na <br /> 831-Davis SL-- - ---- ----- -- _ - - -- - - '+f <br /> u r v�►utee r,� �saa <br /> �yy� <br /> L(+,iu;4`�. <br /> (fl Form�emned ip pe q� 2 q <br /> NON-HAZARDOUS I ley <br /> Ger1crLgtorSPP TAM p l <br /> Document 2 Page 1 <br /> WASTE MANIFEST fVO YH of <br /> 4.1 9.1—ef2(g N—L.g.(Ng 1W,'A9 Address 1649 E . Channell S t <br /> z I03 , St-c)ckton , Ca 195107 Stockton , Ca <br /> 4 Generators Phone( 20 ) 465-3609 <br /> 5 Trarr �t� i Cyi palpep � l r4r� S 1, X15 EPA ID Number ( q a a ) 927—Com` 21 <br /> 7 Transporter 2 Company Name 8 US EPA ID Number <br /> U4,4k924tedjFoIr��i��n A dress 10 US EPA ID Number A Transporters Phone <br /> f ��rte � nc . <br /> b hS s R 3 d N A B Transporter's Phone <br /> C FocalPha e <br /> N07l 451-3276 <br /> 11 Waste Shipping Name Description 12 Containers 13 14 <br /> PP f7Total Unit <br /> No Type Quo tity Wt Vol <br /> 11G L a rd;,u I-ydrocar hon -impacted �"oiI , ACCI=PT V 01165 16 yds <br /> WFJOHMASTER CERTIFICATE <br /> TRIS IS TO CERTIFY that the following described convnadCy was waigtiad measured a counled by a weigtiirsa 4 wlwae sa{{ppnature k on thk Certrfiral0 who k a recagnlzad atA :a of accuracy as prescribed by <br /> Chapter 7(commencing with Section 12700)d Oivisrori 5 of the t aNfarnk 9uairiess and Professions Coda administered by Iha�hrislon d Meatwiametit S1ar,darcin d the CaEtorrrk Depar4rsers1 d Food and Agncullure <br /> We4iAl ,,,,ts, r. iri 1ICKFT NO. : 76780 1 ?• <br /> I a I . I Iii. , 0 . L L ,r�9ifOltt CO. IAIE-. DEC 1, 1993 13 ; 1 / ; 41 <br /> + eilfl,t I I, f lr 4 , Ilky I:,j. Ve1CtkVl ) 1ey (,a. CtJn1nudi ty :C -E301L <br /> , / Pci-ca/UnxL ; <br /> t i i i i Ijl ! I <br /> Total Charge: <br /> r Tendered . 0. '/-IVI <br /> Chang e . � 0. Illi°I <br /> LAI 1 1 ,� i'i 1 z { `J C/ <br /> 1Fl.�i00 (N) 1.)1 te_, a �r. gtit Lbi, <br /> G/'i a20 HUH lie Il,#1L !_bs. SFINDY HALL <br /> �TZtt„il>ti, .tJMy�'{4?GNALTLJff . Tr itui, (4(r. `_'606 DEPUTYWEIGHMSTER i <br /> 16 GENERATOR S CERTIFICATION I certify the materials described above on this manifest are to o lederol regulations for reporting proper disposal of Roxotdous Waste <br /> Printed/TKped Name Signat Month Day Year <br /> arc-lit T,- r Mid Cal Leasing 12 PA J3 <br /> T 17 Transporter 1 AfknovjjadQement of Receipt of Materials <br /> APrinted ype am Signature Day <br /> S - Q <br /> 0 1B Transporter 2 Ac k.-Iedger4enl of Receipt of Materials <br /> R _ <br /> EPrinted/Typed Name Signature Month Doy Year <br /> R <br /> 19 DtbLrepancy indication Space <br /> F <br /> A <br /> C <br /> L 20 Fc cihty Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted in Item 19 <br /> 1 <br /> T <br /> P iniad/Typed Name �� � �� ature Month Day Year <br /> C 22z Z_z4 i-::z 2 624Z� 1 <br /> TRANSPORTER#1 <br />