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ALTAMONT LANDFILL <br /> WASTE ACCEPTANCE FORM <br /> CUSTOMER MANE-. LAV PM- 4CE LIVERMORE NATIONAL. LABORATORY/ <br /> CL'STOlvfER�i -0047 <br /> TRIP TICKET NO. <br /> , TRUCK VOL. O <br /> ?VIATERLAI. 1jESCTLLPTION• ("LASS III COVER SOIL <br /> PROFILE r-408124=:P 16:864-D 1 UI-SPQ;.96 SP/RP No. VOL. A-0 <br /> WASTE SOURCE (Counn- -:•in• location) - LIVERMORE <br /> • The Information listed above is necessary for acceptance of special waste at th,, <br /> Altamont Landfill. <br /> • A copy of this form must be presented with ac )c►ad to the Altamont scale house <br /> collector. <br /> • This form is for Altamc►nt waste tracking rise and is not intended to serge as a <br /> customer shipping document- <br /> Drivers <br /> ocumentDrivers will receive a weight ticket for confirmation of disposal. <br /> • An alternative shipping record may be used in lieu of this form if it includes the <br /> above information. <br /> • If shipping form is a multiple part form, please notify landfill of which copies to <br /> return with the driver. if not otherwise noted on the form- <br /> FOR <br /> ormFOR ALTAMONT COLLECTOR USE ONLY: <br /> FILL rN TAG#SSOCL-�TED %=Ii L0.1D (USE 0UTEOU-N1)4 FOR L'Iv-T.*.RED LOADS) <br /> SCALE HOUSE TAG ;4 - <br /> DATE /� d <br /> TRUCK m <br />