ARCHIVED REPORTS_PUMP RPTS 2015 - Laserfiche WebLink

Home Browse Search

5202 "N NVSS : ll S [H '0i 'qaj ;W11 pania3;� DF 'As�T�1ZENT OF FOOD AND AGRICULT�lRE . . - . 220 N Street and Egg Safety bYanch Manifest-Noi: V A Sacmmento,CA 96814 ' (916)900-:5004 79-124 (EsL 11110 CJ�O Manisne ase ' C`xai� poi-t )ntS #, Ens and Recei g•Faculty Information � - ^•we n r.Ja iA coxa fete `- p Inediia>(e Kitclte Greasy )Traw.Ort 1VYaaifest.far a loan of IKG consists of this form r :ant all ge el<ator copies from AWFS Form.79-125(Mavffest-Inedible Kitchen Grease Transport, "Generator Iri 6oi atioii)'fo"r•gemerators'tltjf_e(ifrWW,& G id the1wd,-A3termat"Iy;theII�G . •tx ansparter map use-other forms that contain an required tuforraation. AIR forms J • • _ each manifest must acre the see l est Numbex; 'x`ranspoxters mast lwe�p:co pl+e e ufests f4ii-two years:. .Nlanffest Instructions: 7.The driver of the IKG transport vehicle is responsible for entering all intrrnaffon on this form and on MPES Form 79- _-'125, Manifest-lne-it)le.Kitchen Grease Transport;.Generator infcin-nzf on.-except.for in the,Receiving Facility :Representative and Generator Representative name and'sign�ure boxes_ All entries must be in ink and legible_ The � driver musunitial•an correcions to urformatinn ' Y atready�entered. • '2. Ener all information in the form below for each toad of IKG. Give one copy of the completed form to the receiving fracilt y a£fhe time ofTKG r"dmipt or mail or`deliver th'e copy to threceiving l'aci6tywifhir,X15 workdays: yl v •+r• - Enter the Manifest Number found.at the,top lof this form in the'Man Fe 1V0" box,on the generator form(MPES Form 79- 126)for each generator that corlibutes o tlie,7oad,,-Ail enera#orfonns from. enerato _ - -. 9.. .. rs where IKG was collected to make up-the load must have the same Manifest Number as the attached Receiving Faoil"dy information form. t •4-Give the generator copy(from MPES Form 7-9125)to the generator at the time of IKG collection or mail,-or def"rver the ' copy to the generator within 45 calendar days_ 8-Attach the gettera�r forms(MPES Form 79-126)for all generators that contiibuted to the load of IKG to this form. Maintain this fommt'and-tlie attached generator forms for two years from the'date on this farm. Date of JKG Receipt: Time of lice FiecslRt Used Cooidng on Typs Of ❑ f IKG: Inte—ptouTrap Grease F Receiving FaarTity Name _ Receiving��ynddn�ti��•�- - - � -775—/ W Total IKG Rewiv - �= M surfing Method Used Goal 3iner Val e'(! Reciuired): Percentage�l{lf Required}: •.� Gallons l ❑ Pounds R ransporterN e: Vehicle Deal Numbe_ P � - Driver Name(prinfed): Receiving Facer Representative Name(Prlrrted): �. Dmi Sig : - ' F2ecefving 1=aafrty representative Sigi,a#ure Zl 'd79L� [ '�N AgE : ll �[OZ 0 [ 'qac . !