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ALTA EMARONMENTAL SERVICES, INC <br /> 831 Davis SLI <br /> Y,4= ' � � k Ds �` -- -- -VacavWe, CA-9S687-,- - —_ <br /> �� (800)794-2766 <br /> l <br /> NON-HAZARDOUS 1 Generator's US EPA ID No Manifest 2 Page 1 <br /> �} <br /> WASTEMANIF1 Ivor APral -)-cbJa Document No of <br /> 3 GLnerator s Name and Mailing Address LOC a t i On <br /> (ylIld CZjI ,-easing 1649 E. Channell St <br /> i- �, tai:,>r 55103 , StOCkton , Ga 95205 Stockton , Ca <br /> 4 Generators Phone( t 0 9) <br /> 465- 3609 <br /> 5 Tronsporter 1 Company Name 6 US EPA ID Number I <br /> t Baworle lrucking I N / A (408 ) 927-9321 <br /> 7 Transporter 2 Company Name 8 US EPA ID Number <br /> 9 gnated Facility Nome and Site Address 10 US EPA ID Number A Transporter's Phone — <br /> C` ..i n 0 1 Land'f i l l I n c 8 Transporter's Phone <br /> ,,1 26 iia,t Road N / A C Facility's Phone <br /> v6cav-1 ile Ca ( 707 ) 451 -3276 <br /> 13 14 <br /> 1 4 Waste Shrpp,ng Name and Description 12 Containers Total Unit <br /> Na Type Quantity Wt Val <br /> a ,r}—t}azardous hydrocarbon impacted SO-11 ACCEPT $1 01165 18 yds <br /> yVER 11161"TER CERTIFICATE�yp� �ao�� <br /> rNIS Is To CEn11FY that the tatl�Mkta dew-rdmd cormwdH wits wMptsed measured or counted by a via=s��id he�lvi�srbn of� stlM>0ra Wrd of the i''zed authority <br /> a p ri rt�rw�t oaf�Fool7 end A�Qnbedn ro <br /> 3hapter 7(curnmenrAng witty Saclaars 2700)a,Division 6 d the GYlornla�ueliwsr atsd F,"*&sione code Y <br /> -F I CKET NO. n 76801 <br /> ' <br /> Tr a 1 . halt y TJr va'ltlfiatiNllt CD. DG1IE: DEC ' 1, 1993 15: 16 : 1:, <br /> +rjt 2atl, �t FITC(. WAfiat. V cCAv111e, Ca. C;arflntadYt:y .C-SOIL <br /> ( (1l)ali 1 SJ Pr-ice/Unit : <br /> total Charge <br /> j) ! Tendered ; $0. 00 <br /> Vl it f I =`k L L , \ 9:;Gt_1 J- 0IA0Ili Change ; $0. 0kZ1 <br /> %a l`J 'A 60111 ilii) EsI c)is- tla tgfitt k_V�. <br /> _ ,_'-r 700_ _ k tot! Wo i rel It <br /> �c'3f `t I��t ll. itllt 1_l�s. :af1NDY HALL <br /> rj <br /> cam(LI <br /> t�l i i rr ia( :L} 1e3 D1 ,'uL I. t I r I. r'�7 DEPUTY WErAMMAS1�ER <br /> 16 GENERATOR'S CERTIFICATION I certify the materials described above on this manifest are ngI!o. arol mouiarrons farereporung proper disposal of Haaardous Wostq i <br /> Printed/Typed Ngme Signator Month bay Year <br /> 41 <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> S �yr G�/Typed Name'�14!J A/ P SignaturL Y w 1 <br /> / s-y Lei <br /> P 18 Transporter 2 Acknowledgement of Receipt of Materials <br /> TPrinted/Typed Name Signature Month Day Yea ) <br /> E <br /> R r <br /> 19 Discrepancy Indication Spacef <br /> F <br /> A <br /> C <br /> II -- <br /> L 24 Facility Ownitr or Operator Certification of receipt of waste materials covered by th manifest except as noted in Ite 19 <br /> 1 <br /> T <br /> __ ------- - Mor y <br /> Print eMN � —� r <br /> TRANSPORTER #1 - <br />