Laserfiche WebLink
rleanHarb(ws <br /> 161MMOMMENTAL SBMCEV <br /> Sart Joaquin County Permanent HHW Collection Facility <br /> 7850 South R_A Bridgeford StreQt <br /> Stockton,CA 95206 <br /> Direct! 209468-5670 <br /> Fax: 209-468-5672 <br /> Inventory Form (Waste Disposal Receipt <br /> Household Infomration <br /> Name:Simplot Phone: <br /> Address: 4863 E Carpenter <br /> City:Stockton Ca 95215 <br /> I hereby swear that the waste I am delivering today was generated in San Joaquin County by a residvoce and not <br /> in a business endeavor. Business waste is a waste generated in the course of doing business,even if that <br /> business is operated out of your home_ Business waste also includes waste generated by churches,schools, <br /> government agencies, non-profits,property management or apartment complex management,far profit ranches <br /> Date: 7-2-09 ITime, 10:27 A Signature <br /> Do NOT WRITE BELOW THIS LINE <br /> INVENTORY <br /> (ro be completed by ccllectim pemormml) <br /> Item Gallons Pounds <br /> Paint Related Material 19.18 163 <br /> Comments_ Referred bx Emrironmental Health <br /> h <br />