Laserfiche WebLink
- - -- - --ALTA ENVIfg0N1lJW_NTAL gMV1I SWC. ----- - - - - - --- <br /> - - <br /> •� AM <br /> Vaca "GA OW87 <br /> �4� (800)784-2786 <br /> NON-HAZARDOUS f 1 G erator s U$EPA ID No Manifest 2 f age 1 <br /> �'at A�1p1 7 c a L Document No of <br /> WASTE MANIFEST <br /> 3�Ci"er(ej: slNor c and Marlin Address O� <br /> ll r ��a� nc 1549 E Channell Sr <br /> !`5103 , Srockt_fan , Cj _ 95205 Stockton , Ca <br /> 4 Generator s Phone( <br /> 209 } 465-3609 <br /> 5 Tfauu orter 1 Campor` Name 6 US EPA ID Number <br /> F. t ai l I. 1,UCIt "Ins; N / A (408 ) 927-9321 <br /> 7 Transporter 2 Company Name 8 US EPA ID Number <br /> 9 Orsrgngfed Fac bty Nark qn de Ad rens 10 US EPA ID Number A Transporter's Phone <br /> n E' cif fa I �r7�7 I � r (]G <br /> B Transporter's Phone <br /> r 1 'i, ti0Ud N A <br /> C Facdl Phone <br /> (, 707 ) 451 -3276 <br /> 11 Waste Shipping Nome and Description 12 Containers ld <br /> Tot <br /> al Unrt <br /> No Type Quantity Wt Vol <br /> Qac,r n � CfvUS hydracarlDan 1fripscted s ci 11 , ACCEPT 01 1 5 18 yds <br /> WEIOIWIABTER CERTIFICATE <br /> 7HIS IS TO CERTIFY that the tolowrsp described commodity was weighed measurod or counted by a woll"ader+whose signature is on this ceiUlcala who is a sulhairy d accuracy as prownbed by <br />:haptic 7(comma ung vii Sectwn 12711 d Owisloir 5 of the California Busmesa and Proteaeiwn Coda admlnittered by lhebrrision d Measumment Standards ol�omia.Depar4nanl of Food snd Agriculture <br /> C-7 <br /> 1niL] Ili r t e l e i F I CKE T IVO. : 76802 _> <br /> i-r x ,ii.r1. L,tavt f uliltill CO. DA-#E DEC 1, 1993 15:06 :Olit <br /> ,lelylr, ll two i„r't Ilic }y Rd VacaVi11ill, Ciel CoI'll III adIty :C-S01L <br /> LttIII1 1'�-, l � ��/ 1-`1 xc�ell.lnitz <br /> F t r i 41� 1 12/,vt wi I iO RL AL <br /> �l <br /> I,, 113 131R1-1- f Tr►1;a1 Chairgez <br /> f�h `tel Tenderil b0. III <br /> VfILI11) 11 1 L v 9568 1 0000 Change : $0. 11210 <br /> SCj L it -1 I r,' <br /> c V10160 tl'! e rthL Lbs- <br /> - <br /> -- ' L_'_79`0 Ial C Wk-- xgiit Lbs. <br /> 50C=€..47t Nt=L Will l flit Lbs bF-NDY HALL. <br /> k <br /> DEPUTY WEIGHMASTER <br /> T ; <br /> 16 GENERATORS CERTIFICATION I certify the matenals described above on this manifest aro not s OjSjov9pregiplalions for reporting proper disposal of Haxardout Waste i <br /> Pnnted/Typed Name Signature Month Day Year <br /> -t.t„) ?iii tc�r rrlid Cal L-aa5-InC� z <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> R — �' Y Month Da <br /> A Printed/Ty l Signatu Y tk <br /> "s cf � �'rr'r1� 1� r �b <br /> P 18 Transporter 2 Acknowledgement of Receipt of Materials <br /> 'r�_ •t <br /> It — <br /> T Ptmted/Typed Name Signature Month Day Year <br /> E <br /> R <br /> 19 Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> 20 Facility Owner or Operator Certification of receipt of waste materials covered byihu manifest except as noted in item 9 <br /> T <br /> Y --_ <br /> 8+rnted/Typed Na a Sr Month ay!u�� ��, I I Y <br /> 1 e <br /> I <br /> r i r TRANSPORTER#1 <br />