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NON - HAZARDOUS WASTE MANIFEST <br /> D 11553 <br /> PROFILE NO <br /> 1-8p0-458-3036 <br /> ❑ BAKERSFIELD 0 YOLO [❑ PHOENIX <br /> NOTE: This form to be in lieu of the Toxtc Substance Controls hazardous <br /> waste manifest To be used for NON-HAZARDOUS WASTES only <br /> Name MR. & MRS. MANUEL SANCHEZ <br /> x <br /> O Mailing Address 1633 W. WALNUT <br /> Q <br /> w City/ State/Zip STOCKTON, CA <br /> Z <br /> UJI <br /> Phone No 209-464-1291 Contact MARY SANCHEZ , <br /> m Signature Date �/�/6/� <br /> W THE GENERATOR CERTIFIES THAT THE ASTE AS DESCRIBEDUJI IS 100°/a NON-HAZARDOUS <br /> I-- <br /> a Waste Description MONITORING WELL SAMPLING <br /> O Generating Location <br /> 1876 COUNTRY CLUB BLVD. , STOCKTON, CA <br /> U <br /> w C�'ll�i� S -v G'Olrtvt � <br /> M Handling Instructions <br /> O Quantity e 0 C ]BBL CX]GLS C ]YDS C ]TONS <br /> CONTAINER TYPE CX]TANKTRUCK C ]DUMPTRUCK C ]DRUMS C ]BINS C ]OTHER <br /> DESIGNATED FACILITY <br /> NAME SEAPORT ENVIRONMENTAL SERVICES ADDRESS 675 SEAPORT BLVD. <br /> CITY/STATE/ZIP REDWOOD CITY, CA 94063 PHONE # 650-364-8154 <br /> IW- MP VACUUM TRUCK SERVICE TICKET# i 273. TRACTIT2 <br /> RLR# �S~/_Z / S C� <br /> MP ENVIRONMENTAL SERVICES, INC Bin Nos -'✓ <br /> O 3400 Manor Street Signature - <br /> N Bakersfield, CA 93308 Date <br /> Q 805/393-1151 P U DATE OZ- d M c G Job# <br /> iz <br /> H <br /> Name SEAPORT ENVIRONMENTAL SERVICES Disposal Method <br /> Address 675 SEAPORT BLVD. ❑Landfill Other <br /> } <br /> a City/State/Zip REDWOOD CITY, CA 94063 <br /> U <br /> Phone No Time am <br /> pm <br /> p Discrepancy <br /> 10 <br /> Signature Date <br /> GENERATOR RETAIN <br />