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ALTAMONT LANDFILL <br /> �� <br /> WASTE ACCEPTANCE ANCE i <br /> CUSTOMER NAME: L.Aa'RENCE LIVERMORE NATIONAL LABOR=..TORY <br /> CUSTOMER# •0047 <br /> TRIP TICKET NO. 21-- <br /> MATERIAL DESCRIPTION: CLASS I? COVER SOIL TRUCK VOL. Z� <br /> PROFILE a 40512%AP16:S65-D1U1-SP108 SP/RP NO. VOL. <br /> WASTE SOURCE (County / City location)• LIVERMORE <br /> • The Information listed above is necessary for acceptance of special waste at the <br /> Altamont Landfill. <br /> • A copy of this form must be presented with earb h2ad to the Altamont scaly house <br /> collector_ <br /> • This form is for Altamont waste tracking use and is not intended to serve as a <br /> customer shipping document. <br /> • Drivers will receive a weight ticket for confirmation of disposal <br /> • .An alternative shipping record may be used in lieu of tziis form if it include., tJe <br /> Above information. <br /> • If shipping form is a multiple part form, please notify tan i of which copies to <br /> return with the driver.if not otherwise noted on the form. <br /> FOR ALTAMONT COLLECTOR USE ONLY: <br /> FILL IN TAU##ASSOCIATED 1XTTH LOAD(USE OUTBOUND#FOR UNTA:?.ED LOADS) <br /> SCALE HOUSE TAG #- 20-)-/ — 1 <br /> DATE G Z j / �^ -• --- <br /> TRUCK <br /> i <br />