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r _ _ ALTA ENVIRONMENTAL SERVICES, INC. <br /> 831'DavES St - - -- - -- - - - - -_ - r - <br /> k <br /> em <br /> � Vacaville,CA 95687 � <br /> , (8010)794-2788 <br /> � <br /> NON-HAZARDOUS I Generators US EPA ID No + Manifest 2 Page 1 <br /> WASTE MANIFEST <br /> N O t Applicable Document No of <br /> 3 Generators Nome and Mailing Address <br /> MiJ Cal Leas-trig 11,649 E . Channell 5t <br /> P 0 toi 55103 , Stockton Ca 95205 Stockton , Ca <br /> 4 Generators Phone( 2 0q,) 465-3609 <br /> S Transporter 1 Company Name 6 US EPA ID Number (4 0 8 ) 9 2 7"9 3 2 1 <br /> K Bauer le Trucking i N l A <br /> 7 Transporter 2 Company Name 8 US EPA ID Number r <br /> 9 Destgnated facility Name and Site Address 10 US EPA ID Number A Transporter's Phone <br /> 6 a in d .1 Landfill , 1 n c B Transporters Phone <br /> 1;4 2 o Fi d y Road N / A C facility's Phone <br /> Vacaville , Ca (747) 451-3276 <br /> 1 1 Waste Shipping Name and Description 12 Containers 13 14 <br /> Total Unit <br /> No Type Quante Wt Vol <br /> allon-hazardous hydrocarbon impacted soil , ACCEPT . V 011165 18 yd <br /> WEIGHMASTER PO"Illi <br /> TKS IS TO CERTIFY that the following descnbed cornmodty was wefgtsad,measurect or tainted by a wsfoMPaMer,tYI+OM naWre is an Iriis caAllcale who IS a ro�Dthonry of accuracry ae preacnbed by <br /> Chapter 7(commenung with Section 12700)d Division 5 of the Cardomits Business and Profession Coda �by Iha d klaaartrerrtant Standards of Itsa W.W.C DeparlmeM d Food and Agriculture <br /> a <br /> I <br /> W U2 + ,t I i„ a t L I CKET No: : + 76#103 t,p <br /> !► t Viii ,i l:t vf: ] c,ltilnaaTii Ct7. <br /> DATE« DEC 1, 1593 15. 12.-�t6 <br /> xt�Ii ,t i c i._f IIaV Rd. Vacav x 11e, G i. Ca in iiodiity :C—SOIL <br /> 1,11t1lIi LF <br /> `�: ! '-r Un I <br /> �+ eli <br /> L I fi i iSV I IUMAN lldormolw P l W`I <br /> I i YJ t tr ', I I.E.I.. I- Total Chargt; <br /> err, t ' Tendered : s(a.-00 <br /> 9 643 -000 1A Change : te).+kl�� iZtw is <br /> Si 1�1 EI 41i! ► `- `� � . <br /> e ifs r rift Lb+r. ;r'p <br /> J� � " 5x5,960 Net, k It_ , Lel i i. L.b ii blaNDY HALL <br /> a <br /> rii, <br /> ii At <br /> s .. ! <br /> nlxt,l111f3 : L6tPGN1LTUffi_. - 11 k Pi t1. 151i "M <br /> DEPVTY YYf:IGF11AIiSTER <br /> Printed/Typed Nome Signatur r. Month Day Year, ice+ <br /> f1 2 01 e9 3 <br /> Mid Ca 1 _Leas i n <br /> RT 17 Transporter I Acknowledgement of Receipt of Materials "7 * <br /> N Primped Name / 5ignatur nfh Day <br /> 5 C�a z A <br /> P 18 Transporter 7 Acknowledgement of Receipt of Materials `9 <br /> TPrutted/Typed Name Signature Month Dai Y4e, tfar <br /> t a rf� <br /> 19 Discrepancy Indication Space <br /> r <br /> r <br /> F Ys <br /> A ` <br /> I <br /> L 20 fadhty Owner or Operator Certification of receipt of waste materials covered by his manifest except as noted in Item 19 <br /> 1 <br /> T <br /> 1Mon <br /> „ Pruned ped Name Sign re <br /> 6 <br /> tf� <br /> ti <br /> TRANSPORTER #i <br />