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Address: 4946 East Eight Mile Road, Stockton Record ID: SR0083261 <br /> Date: February 16, 2021 <br /> Comment: Tank is removed and receipt attached. <br /> STOC <br /> -ro BI <br /> �e PLEASE PRINT A <br /> Waste Hauler Company Nan <br /> dW <br /> Vehicle License No. <br /> Complete name, address, <br /> representative from each s <br /> load;attach additional form <br /> RICHARD'S PUMPING&EXCAVATING, Inc. 1. Nam."" <br /> 10227 East Hwy 26 i Address:_ <br /> Stockton, California 95215 Invoice NO- <br /> (209)934-1844 3 <br /> Phone No.:( <br /> Contractor's Lic.#850703 y <br /> Waste Type: <br /> NAME --_ _ - [JATL.. / .. f <br /> Generator Signature:_ <br /> r <br /> ADDRESS - _ - � Date: <br /> Within Stockton city lir <br /> BILLING ADDRESS <br /> r <br /> CITY - STATE ZIP PHONE - t�- P <br /> CA,4H CHARGE CHECK O r <br /> QUANTITY DESCRIPTION AMO NT <br /> t <br /> Allow able Waste Typ. <br /> 1. Residential Septage <br /> :Signature will not be rel <br /> 'A Special Permit must <br /> I, the below named v <br /> described the type, qt <br /> under penalty of perjL <br /> this waste was receive <br /> case of a Special Per <br /> Control requirements <br /> / materials characterize <br /> % and requirements of <br /> information or failure <br /> TAX immediate suspensi< <br /> RECEIVED BY TOTAL - <br /> r <br /> -- ,i <br /> I � ' <br /> February • 2021 • : <br /> Aaron Gooderham, REHS Page 2 of 2 <br />