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--,a SO Pi ► WESTATES CARBON PRODUCTS NON -HAZARDOUS MANIFEST PKM10001 CONSIGNEE O: SHIPPER (FROn: ❑ Westates Carbon -Arizona 2523 Mutahar Street Parker, AZ 85344"I"C 1 t E (1 ;,F q''5 -7 2 t l SIGNATURE: �i Westates Carbon -California 11711 Reading Road Red Bluff, CA 96080 14 Is Job#: 3 / s qoS Ok No. Shipping Units TYPE • DESCRIPTION WEIGHT SIGNATURE: :r✓10 SIGNATURE: Sent Carbon — Non -Hazardous Waste 14 Is RECEIVED BY (FULL. NAME): DATE: SIGNATURE: if 17 li Name of person signing for Generator Circle one• UA VAPOR Prof le # 7 A1-cro ER I111RORN ATION: TE '. DA! j — --- PRINT NAME: NAME OF CARRIER N2: SIGNATURE: :r✓10 SIGNATURE: 1 TRANSPORTER: NAME OF CARRIER N 1: WESTATES CARBON DATE: SIGNA f-�,' NAME OF CARRIER N2: DAlrE. SIGNATURE: 1 14 Is RECEIVED BY (FULL. NAME): DATE: SIGNATURE: if 17 li 1.) Name of Generator 2.) Generator site address 3.) Given' job number 4.) Number of units being picked up 3.) Type of unit being picked up 6.) Total weight 7.) &) Profile number, MANDATORY Date service. agdtor pick op performed 9.) Name of person signing for Generator 10.) Sipature of person in box 9 11.) Sante at box 6 12.) Signature of driver for Transporter #1 13.) Name of carrier transporting to Plant 14.) Date the load was picked up to go t6the Plant UP Driver's signature for.Transporter k2 16.) Full name of Receiving person 17.) Date received into Plant 1&) Signature of Receiving person n0", ZJ)Mous Ka U= WHITE: THE PLANT YELLOW: TRANSPORTER *2 MK: IF= COLD: GENERATOR