Laserfiche WebLink
Event: <br /> hiotrennber 1fi,2018 a <br /> 00 pate of�unG g 3+Jelttt N <br /> O (a <br /> 1.0 <br /> O J� 11R53 Will lli It(1t'x j1i Jh115749 <br /> It p1tn� xd N <br /> }- <br /> �� Stefj yde 9A'9'HC�M tx YA. <br /> d > s (916)351 TOR WASTE <br /> GENERA <br /> E ami Srd QUA ON STA'�M1ENT <br /> ca A.CSRT'r' <br /> o � � COIYDiT[DNA IN R�� CA <br /> ami o .� CIifECK- BY GENERATOR <br /> d TD BX CowT,�TEp for Pslticlpation in the <br /> e requirements Exempt <br /> f— [and th that 1 am a Cond eed the <br /> specified <br /> ct,and 1 have read and and.0t. I further ceRify not exceed the spec <br /> y inParmation is come to Acceptance prog uandty of waste does t aCCept� <br /> that the foYlowing uatity Generator W� uiatioo,and this q rials[►o <br /> I cattily BxemPt Small Q lifornia State reg uantity limits or co[ttairt mate <br /> i Staricyele CondillaneilY do in by Federal and Ca m exceed small 4 regulations as aPP� �' <br /> Geaeralor as If this waste is cater found comply with other state g <br /> Small Quantity r waste being dispo <br /> cinder this Prp�1 agree to comPlB1e a hazardous waste manifest and <br /> COMPANY REP: Athena LaRue —�— <br /> ooI S rvice&ANor EPA[D�: CAL 414633 <br /> COtypANYNAME: I a e Yosemite Avenue <br /> COMPANYADDRE5' 1' t! SIGNATURE: <br /> o CA 95338 DATE: <br /> CITY,STATE,ZIP: �a � goo nano TITLE: v�E�v1SoQ <br /> COMPANY PHONE: (249) ="� <br /> TQ BE CpHIpLETED BY STERTCYCLE CEEC K-�ATTENDANT <br /> #QF h0" <br /> CONTAINER WASTE urr(L13) DISP. COST <br /> GENE LWAS?EDFSC1t[FTION }I147.ARD ty g STATE COD6 L CONT T"YFF1C17.F: AMOt1N7' <br /> C nttcAr.rnNsnru�NT r>x trrc 5 5 a[ 218.4 305.7 <br /> 7� Chlorine Table's <br /> t.. <br /> 'C <br /> iv <br /> O <br /> 'C <br /> ti <br /> N Processin Fee <br /> cd20. <br /> 'u tz��� <br /> YMEfV I_ <br /> CASH p CCK. <br /> A <br /> CH8C1C No.-2 C <br /> U STERICYCLE CHECK-IN ATTF.NOAN'1'S INITIALS TOTti PAID$ 7 <br /> DATE <br /> > CHECK-IN REC <br /> LU <br /> a) <br /> U) U <br /> � O <br /> uj o <br /> O y <br /> O O G <br /> ao cn <br /> Cu <br />