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• <br /> ' ALT LANDFILL <br /> WASTE ACCEPTANCE FORM <br /> CUSTOMER NAME. LAV=-NCE LIVERMORE NATIONAL. LA-BOR.ATORY <br /> CT`STOMER*i 0047 TIttP TICKET O <br /> , <br /> -MATERL,L. DESCRIPTION- CLASS III COVER SOIL TRUCK VOL: <br /> � <br /> ' `- -C i ` ` SP/RP NO.-__ VOL. <br /> PROFILE r-405124--.P1..86., D1 U1 ..P9_._6 <br /> WASTE SOURCE (County- -.;ity location) - LIVERMORE <br /> • The information listed above is necessary for acceptance of special waste <br /> at tho <br /> Altamont Landfill. <br /> • A copy of this form must be presented with ae Ic►ad to the Altamont scale house <br /> collector. <br /> • This form is for Altamont waste tracking !,se 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 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 ALTAMONT COLLECTOR USE ONLY: <br /> FILL IN TAG#ASSOCL-�TED %VITIH LOAD RUSE oLRTOUND4 FOR UIvT.'RED LOADS) <br /> SCALE HOUSE TAG <br /> DATE <br /> TRUCKIr <br /> 382 <br />