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i <br /> NON-HAZARDOUS 1 Generator's US EPA ID No Manifest 2 Page 1 1 <br /> WASTE MANIFEST I I upa>umgntNa of <br /> Gendrator's Name and Mailing Address SLABY SALES INC, <br /> ite@ 3012 E. Wterloo Rd P. O. Sax 903 <br /> Stockton CA 95205 BORREGO Spring: CA 92004 <br /> 4 Generator's Phone( 760 ) 767-0776 <br /> 5 Transporter 1 Company Name 6 US EPA ID Number A Transporter's Phone <br /> SLABY ENVIRONMENTAL INC. A 760 767-0776 <br /> 7 Transporter 2 Company Name 8 US EPA ID Number B Transporters Phone <br /> 9 Designated Facility Name and Site Address 10 US EPA ID Number C Facility's Phone <br /> L&D Landfill <br /> 8635 Fruitridge Road <br /> SACRAMENTO CA 95827 IC A L 0 O 0 2 7 7 7 5 7 (915) 737--8640 <br /> 11 Waste Shipping Name and Description 12 Container 13 14 <br /> Total Unit <br /> No I Type Quanta Wt/VoI <br /> a Non Hazardous Waste Soil <br /> 0 1 8 D M 0 8 1 3 6 P 4 <br /> G b i{ <br /> N <br /> E <br /> A <br /> A c <br /> T <br /> U } <br /> R <br /> d <br /> I <br /> D Additional Descriptions for Materials lasted Above E Handling Codes for Wastes Listed Above f <br /> I <br /> 1 <br /> 15 Special Handling Instructions and Additional Information <br /> Emergency (24) Hour phoney (888) 701-6600 Site Advanced GeoEnvironmental <br /> Arroyo Smoke Shop <br /> I <br /> *** BILI, Slaby Sales Inc. *** For DifigQSAL 3012 E. Waterloo l <br /> PO BOX 903 STOCKTON CA 95203 lIl <br /> BORREGO SPRINGS CA 92004 <br /> s< <br /> 16 GENERATOR'S CERTIFICATION I certify the moienals described above on this manifest are not sublect to federal regutotfons for reporting proper disposal of Hazardous Waste <br /> Panted/Typed Norm Signature Month boy Year <br /> for Advanced GeoEnvironmental 0 813 110 5 <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> APnnted/Typed Name Signature `r, M Day Year <br /> N <br /> S Al. HER REA <br /> p18 Transporter 2 Acknowledgement of Receipt of Materials <br /> T Printed/Typed Name ShQnature Month Day Year <br /> E <br /> A <br /> 19 Discrepancy Indication Space <br /> F <br /> A <br /> C J <br /> 1 <br /> 20 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted lin Item 19 <br /> Printed/Typed Nome Signature Month Day Year I <br /> j <br /> i <br /> I <br />