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JUN-IS-SB 4e9- 18 FROM:ALTAMONT LANDFILL & RRF ID: FACE 4/4 <br /> LALI.TAMONT LANDFILL <br /> WASTE ACCEPTANCE FORM <br /> CUSTOMER NAME: LAWRENCE LIVERMORE LAB <br /> CUSTOMER# -0047 <br /> MATERIAL DESCRIPTION: ASPHALTICONCRETE <br /> PROFILE4 408126-AP16:865-DIU1-RP94 <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 each load to the Altamont scale house <br /> collector. <br /> • This form is for Altamont waste tracldn-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 this form if it includes the <br /> above information. <br /> • If shipping form is a multiple part form,please notify laxkdfffl of which copies to <br /> retarn with the driver,if not otherwise noted on the form. <br /> FOR ALTAMONT COLLECTOR,USE ONLY: <br /> FILL IN TAGO ASSOCIATED WITH LOAD(USE OUTBOUND4 FOR UNTARED LOADS) <br /> SCALE HOUSE TAG 9-— 'P 4Q c:;)L — / <br /> DATE fz 96 <br /> TRUCK <br />