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ALTA ENVIRONMENTAL SERVICES, INC. <br /> _ 831 Davis_SL <br /> - _ -f VacavI1Ier CA 95687 = <br /> tt:isrini ;1 1 i (600)794-2768 <br /> rise ion al _ <br /> Manifest 2 Paae 1 <br /> k ' :1 ,G,enerator' USE AID No f <br /> y� NON-HAZARDOUS t-tsh,�- IVC�t �pp� y G T�}) I E Document No - of <br />,r WASTE MANIFEST _ <br /> Geiser ori Name and MadAddress <br />+ ct I Basin 1649 E . Channell 5C <br /> tn <br /> Bo 55 10 3 , Stockton , Ca - 9520b Stockton , Ca <br /> 4 Generators Phone( 2 0 9 ) 465-3609 <br /> $ Tra orter 1 C mean Name 6 r� YS E�A ID Number (4 0 6 ) 927-9321 <br /> f ` 'at.er`1, fruckirig / <br /> 7 Transporter 2 Company Name B US EPA ID Number <br /> 9 Uesiggn ted Faclhty Na qnd tie Address 10 US EPA ID Number A Transporter's Phone <br /> f n f s J t o T1 C� 1 I Al <br /> r1 C B Transporter's Phone <br /> # #i a`,' r<,7�ca tI N / A <br /> C Facility's Phone <br /> Ile , Ca (707 ) 451 -3276 <br /> — -- 12 Containers 13 14 <br /> 11 Waste Shipping Name and Description Total Unit <br /> �- No Type quanta Wt Vol <br /> Non- hazardous hydrocarbon impacted soil , ACCEPT U 0 i 1 5 18 ydsWEIGMASTER — <br /> i <br /> HIS IS TO CERTIFY thet the IvMrnw+p descrbed commodity <br /> was welptted measured,a cam+ ,%%;CERTIFICATE wnature Is on this teAiBule who Is a==I.Dep.hortty i accurecy as prescrn <br />:hrpter 7(tonvnenctnp with Section 12700)or Diwsivn 5 M the CaYiornia Buai and Prdesarons adminntared by the Rion d Meawismerd tslardarda d the Is Dapartrrbnt d Food a rtc <br /> I L KET NU. s 76 807 <br /> DHT6' sk9'93 # <br /> T>"1 1 VItI y Dili, e].L�Floelit Go. l <br /> Wti13.s11t, 7 Ib slay Rd. Vacaville, CSA. Camm�idity :C--SOIL ' I <br /> f .i -,-/ <br /> 1 s E ;t1 i Ft, 1 <br /> it IN rlORCA1 [ <br /> llrst: ! Total Ch <br /> t1 Fol L-C e rges r <br /> Tendered : <br /> f Change : so. ov, ° t <br /> rV"(.I 1 l 1�f� t ` 95fai3/ �ZIu1IbaLt {f, ry <br /> bi)lt It 0L IC`, ' <br /> x <br /> t1i. iL. <br /> ght fLbs. ti <br /> 1ght bs. <br /> PJet Wt 1 t1#1t SPINDY BALL <br /> r' 1 i7 ! +`t!(_�. I l') -.A0 1 a . DEPUTY VrUGHMASTER <br /> i <br /> 16 GENERATOR'S CERTIFICATION I°cerhfy the materials described above on this mondes ars no sub to ederal re Moho for repo r disposal of Roxordous Waste Hs+ <br /> Printed/Typed Nanfe Signatu Month Day `LYea ` <br /> 4tjet-IL tat•• ' Mid Cal LeaSing <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materialsr <br /> N pr f �ame _ ` S nature � -h ~ <br /> 211 <br /> R 1 B Transporter 2 Acknowledgement of Receipt of Materials <br /> Signature Month Day <br /> PanteFt Typed Name t t <br /> E } <br /> 5 sir <br /> 19 Discrepancy Indication Space <br /> r. <br /> A c �, <br /> C <br /> I <br /> 20 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted to Item 19 <br /> Y _._ __ Signal Month D y Y ar <br /> f iu ed i Name J f g 1 <br /> LlElry/ c <br /> Lj4 f <br /> r ' <br />�� I TRANSPORTER #1 <br />