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e <br /> ALTAMONT LANDFILL <br /> WASTE ACCEPTANCE FORM <br /> NCE LIVERMORE NAT] L�EORATORYCLSTOvER NAME. LAVE <br /> r <br /> zPlt <br /> CUSTOMER# 0047 <br /> h ; <br /> P fir NO <br /> � ., <br /> MATERL�L DESCRIPTION- i-L ASS III CU`'ER SOIL T-R'tJ po . <br /> SP/RP r[O:" VOL. <br /> PROFILE r-405124-=.PI6:86d-DIUI-SP9'-)-.96 <br /> WASTE SOURCE (County City locarion) - LIVERMORE <br /> • The tnformition listed above is necessary for acceptance of special waste :at tho <br /> Altamont Landfill. <br /> • A copy of this form must be presented with gacb load to the Altamont scale house <br /> collector. <br /> • This form is for Altamont waste tracking kvse and is not intended to serve as a <br /> customer shipping document <br /> • Drivers will receive a weight ticket for confirmation of disposal. <br /> • 4n alternative shippinb record may be used in lieu of this form if it includes the <br /> above information. <br /> • If shipping form L% :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 ALTAMOINT COLLECTOR USE ONLY: <br /> FILL TN T:AGA a SSOCL- TED WMH L(_).�LD (USE OLrMOUNI? FOR L'T T.'RED LOAD`) <br /> SCALE HOUSE TAG 4 - 171? _ 1 <br /> DATE <br /> TRUCK R � -- <br />