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JUN-IS-SS 09: 18 FROM:ALTAMONT LANDFILL & RRF ID- FACE 4/4 <br /> A I TAMONT LANDFILL <br /> r"kl.d <br /> WASTE ACCEPTANCE FORM <br /> CUSTOMER NANS: LAWRENCE LIVERMORE LAB TRIP TICKET NO.. <br /> TRUCK VOL. -2-0 <br /> CUSTOMER# -0047 SP/RP NO. VOL. 45 <br /> MATERIAL DESCRIPTION: ASPHALTICONCRETE <br /> PROFILE 4 408126-AP 16:865-DIUI-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 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 this form if it includes the <br /> above information. <br /> • If shipping form is a multiple part form,please notify lartdfiffl of which copies to <br /> return with the driver,if not otherwise noted on the fornL <br /> FOR ALTNT COLLECTOR USE ONTLY: <br /> FILL IN TAGO ASSOCIATED WITH LOAD (USE OUND#FOR UNTARED LOADS) <br /> SCALE HOUSE TAG n C6 - 1 <br /> DATE 215 - Z6 <br /> TRUCK# Z <br />