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/ I • - <br /> ALTA Eh3YiRONM33NTAE.SERVICES.INC. <br /> 1331 DaVIs St <br /> E{ Ir <br /> -.` ---- -tla(8.8WVr^l)):N-il.7'f 27a0 GA-95W---- _ <br /> �print pi tiI , aI i Y <br /> das r>md for u onto 1 <br /> NON-HAZARDOUS 1 Generator's US EPA!D No Document 2'Page 1 / <br /> } WASTE MANIFEST y root Appl 7 c 3b F of /y <br /> 31 Gr net tors Name and Marling Address 1 4 t� r hpl l i f"1 rpt <br /> C', c l ea E. l n'0 <br /> 1 sic, , 55103 . Stockton , Ca 95205 Stockton . Ca . , <br /> b Generator's Phone( 9 ) 465-3609 <br /> TransPorter 1 om an Name 6 US EPA ID Number <br /> ISt!� Ii- Iruc ,ng IN / A (409 ) 927-932 <br /> 7 Trunsporter 2 Company Name B US EPA ID Number <br /> 9 D signoted Facility Name and Site Address 10 US EPA ID Number A Transporier's Phone - <br /> t, 7' t a r i d f-1 1 I 1 ri G B Transporter's Phone <br /> h t I a y Ff(":i C Facility's Phone <br /> (707 ) 451-3276 <br /> 12 Containers 13 14 <br /> 11 Waste Shipping Name and Description Total Unit <br /> No Type Quantity WI Vol <br /> �_ hGl�rdcai hydrocarbcti lriipar-ted I , ACCEPT V 0116 ycf-4 <br /> WEISHU"TER CERTIRCATE <br /> FMS IS TO CERTIFY that the loilowing described commodity wrss weighed mstnured,or counted by e wesghmadar whose i4nature Y on this cadlic0le who his.a recognized authority of accuracy as prescnned by <br /> Chapter 7(commencing with Section 12700)of Divhion 5 of Itis California Business era Prafesabns CA)de adninislared by"Division of Meaawamem 8lwx ds of Ilse California Department of Food and Agriculture <br /> e <br /> � f <br /> Ljte l t4l i ri ., t. 5-i . T IC,KE T NO. : 76790 (Z--) <br /> IrT <br /> I. �,itiiL ; i1� lclpflletlt Ct►. DAIE: DEC I, 1993 1 x: 41 :51 <br /> r1i ,i i1 I" 11<.y Lits. Vci(-aV 11 1e CoIll rnodity :C--50IL <br /> .111 +i1i ir.r ; / F'► <br /> 0'0 ' €4 1.114V 1 Nr14011 I`ORC AI /� P <br /> r <br /> f1�L 1,115 1 :ti ;�l t I Tote] Charge : <br /> r,l ( D l endered : �.V-1 V10 <br /> Vile 1!t Ll 1 i , f3:It,zi IZirli�tLf Change ; (rp0. a!illl <br /> BUIL ,L 01 It i <br /> •"1 <br /> /+71LO 04) ('r t1: b W'! 1!j11t L_b6. _ f <br /> /60 rral +� LJ,' ltiliL 1 L►�. <br /> ,j7._60 ldut Wf- i gIit Lh. ,. VINDY VIAL_L.. „ <br /> f '"'1'"fes r k-iA t_k L I u. 121*6 DEPUTY W€IGHMASTER <br /> Printed/Typed Name Signature Month Dar Year <br /> ailr I,C Vor Mid Cal Leasing A 2 1 3 <br /> T 17 Transporter I Acknowledgement of Receipt of Materials } <br /> pPrrnled y Signature M nth Oy <br /> S <br /> U IS Transporter 2 Acknowledgement of Receipt of Materials <br /> R --- Month Day"+s'Year� <br /> E Printed/Typed Name Signature ! <br /> r <br /> R it <br /> 19 Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> I -- <br /> L 20 Facility Owner or Operator Certification of receipt of waste materials covered by this monsfesi except as noted in Nem 19 <br /> I ' <br /> T <br /> y ----- <br /> Yn ted/T ped Nam � ature o Da Year <br /> 10 <br /> r ;-, A{� <br /> rE t k k Y TRANSPORTER#1 <br />