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Sap-09-o2 U:0 i Pm rom-aItamoi ndti l 9i549B7383 7-4U P 002/002 F-E'o <br /> ALTAMONT LANDFYLL <br /> WASTE ACCEPTANCE FORM <br /> WISED <br /> CUSTOMER: Keystone Automotive Inc. <br /> CUSTOMER# 0387264 <br /> GENERATOR: Keystone Automotive Inc. <br /> PROFILE#: 55105700 <br /> LIST WASTE SO(JRCE: (County/City Location) San IoaquinlStockton <br /> MATERIAL DES C RPTION: Class I1 Drum Disposal <br /> FLAG COLOR: BLUE <br /> The Information firted above is necessary for acceptance of special waste at the Altamont <br /> Landfill 7 <br /> A copy of thisform• must be presented with each load to the Altamont Landfill scale <br /> house collecto . <br /> tracking <br /> This form is f r Altamont Landfill waste ;use and is not i�atended to serve as a <br /> ctistomer shipping document. <br /> • Drivers will r ceive a weight ticket for confirmation of disposal. <br /> • An alternativ shipping record may be used in lieu of this form if it Includes the above <br /> information. <br /> • If shipping form is a multiple part form,please notify landfill of which copies to return <br /> with the driv r,if not otherwise noted on the form. <br /> FOR ALTAMO 'T LANDFILL COLLECTOR USE ONLY: <br /> FILL IN TAG# SOCIATED WITH LOAD (USE OUTBOUND#FOR LNTA ED LOADS) <br /> SCALE HOUSE rAG#- <br /> DATE <br /> TRUCK 4 <br />