ARCHIVED REPORTS_PUMP RPTS 2016 - Laserfiche WebLink

Home Browse Search

9210 "N AVL0 : 11 9102 '0 '110 awil p;AI ;);d 5-MM OF CAL[FORIUA l7EPART YMNTOF FOOD AND AGRICULTURE Meat,Poultry and Egg Safety Branch / 1220 N street: Manifest No:: C7 Sacramento,CA 95814- (916) 5814(916)900`5004 79-124 CE t 11112) Manifest - Inedible Kitchen Grease Transport Instrueflons and ReceiVm_g Facility Information (D .A complete Inedible fatcheta Grease �Transport 1V��o�.xfesf for a load of IKG consists of this form i .,and aU generator copies Exom MPES°Forma 79-1-25 (Manifest-Inedfl)le Kitchen Grease'Transport, Generator Information)for generators that Contribute 1KG to:theioad. Alternatxve)y,the 1KG transporter may rase other forms that contain aU required information. AR forms in each manifest must 1 'have the same M ugest Number. Transporters'mirst keep complefed manifests for.two years. Manifest Instructions_ ;I 1.The driver of the IKG transport vehicle is responsible for entering ail information on this form and on MPES Form 79- 125, Manifest-Inedible Krtchen Grease Transport, Generator Irrform*tUon,'.axcept for in the Receiving 1`acTrty Representative and Generator Representative name and signature boxes_ All entries must be in ink and legible The L driver must initial any corrections.to information already entered; 2. Enter all information in the form below for each load of IKG_ Give one copy of the completed form to the receiving facilrty at the time of IKG receipt or mail or dealer the copy to-the receiving facility wifihin-15 work-days. ._3. Enter the Manifest Number found atthe top pfthis form in the Manifest No- box.on the generator form (MPES Form 79- 125)for each generator that contributes to the load. All gener$atof,forms.from generators where IKG was collected to make up the load must have the same Manifest Number as the attached Receiving Facility Information form. t 4. Give the generator copy(from MPES Form 79-125)to the generator at the time of IKG collection or mail or deliver the copy to the generator within 45 calendar days. _ 5_Attach the generator forms (MPES Form 79-125)for all generat6rs that,contributed to the load of IKG to this form- Maintain this form and the,attached generator forms for two years from the date on this form_ I Qate of IKG Receipt Time of IKG Remipt- T © Used Cookfng Oil Al� IKG: Interoeptorlrrap Grease Ree wmg Facility Name- Li ..� k. Peoeiving FaaTiiyAddn sis-- Total IKG Received: �-r �., Measuring Method Used: Container Volume'of Requm . Percentage Fill(if Required): ir�Tdllons Pounds Q C4 Registarad Transporter Name' Vehlcle Decal Number- 16 umber j Driver Name anted): Receiving Facifity Reprepfent@ltive Name(Printed): _ _ l Driver igna{ure: Recrrrnng dlfty rasentattve Signature-' i r' S 'd 0619 N Wdll l l 9lOZ O l 0