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w.nfi� q r- <br /> "✓t <br /> ALTA EwRON�t}�IENT�Ar.L�SERVICES. t <br /> -V X10 CA 9W7 <br /> - - - -- _ <br /> M 9C <br /> , <br /> '1 NON=HAZARDOUS'` I GfYOC°►AUS EP�1�D No Manifest 2 C, 1 <br /> WASTE MANIFEST Fop 1 on Document of <br /> I <br /> IqlF13 Geryergtpr's!1or�e dnd n�Address �a��� (��' 1649 E . +Channell St <br /> , <br /> l �[l L x 1.� I� � <br /> B0ni"555163;` Stockton , C3 - 95205 Stockton , Ca . <br /> 4 Generators Phone{ <br /> X209 465-3605 <br /> 5 Tranlporter I C an Name h US EPA ID Number <br /> `£ -f\ _rsaue r r Ucking N / A _ (406 ) 927-932 1 <br /> ?7 7 Transporter 2 Company Name 8 US EPA 1D Number <br /> +c 9�t DesignaledFaci ty Nartl ono$,Ile Address 10 US EPA 1D Number A Transporter's Phone <br /> Cff Ezra i"t Gt I I a Transporters Phone <br /> 'O H o y R o a d I'd / A C Faal,7',Phone <br /> 2 <br /> `4 <br /> v--.c t' vl 118 , Ga ) 451- -275 � <br /> _ 1 I Waste Shipping Name and Description 12 Containers 13 14 i <br /> Total Unit I <br /> <t <br /> No Type Quante Wt vol <br /> s "N, ll- iz8L7ar'Linll-S _1ivdvor-anbc�n lirrnimctt of sLia L -- rACGEPT P 011 $5 <br /> WEIGHMASTER CERTIFICATE <br /> i5 IS TO LEHTIFY that the lot e=described commodity was we{pliect measured w <br /> or counted by a weighmasler whose signature a on this cerld"te who is a recognized authority of arracy as prescnsetl by <br /> r`ter 7{comm8ncin9 mth Section 12700)of Dm won 5 of the Callornis 8usnem and Prdewxm Coda administered by the Division o1 Measuremarsl Standards of the California Department of Food and Agncuttare <br /> } <br /> ,, t t f I L i<LT 110. - 761594 15 <br /> : r , A / 0evu- tu rilell1 Co. DML . LXC 1 , 1993 0 .C�J;s ] <br /> f 1 rt w Gi r° ! raL_L ii,�v REI. V,_�c_av 7 ] l t_, l_, C_owIto odi t ' C. -L30IL <br /> LI tsil, ' J 1 1 't I%--k- /LJna L ; <br /> s t_t I ' t t,, t 100 I ILII{C III /v f`"- _ <br /> ltrti I `, I RLI I �� l ut,aL Charge : <br /> r r <br /> 1 end ered : 9.0, 'L /4 <br /> LJhungc . i0. 0o <br /> I t I rr,t l rw <br /> f3,- L ; hint l-t <br /> ZI(31 I <br /> r;F 4 Cr i i i t , , , t I i i , )t;i}]_i`r i I1"il.. L <br /> i I n I In 'Yl" 1SSG 1 1) . I t'i l.-.I ( I,r I.l:t1 DEPUTY WEIGHMASTER <br /> i <br /> I b GENERATOR 5 CERTlRCATION I cer,rfy the maienols desrnbed oboe on this mor,Frsi are not subryt1 to laderaVregulasions for reporting proper disposal of Hazardous Waste <br /> — Pnnte d/Typed Name Signature /' ��',c Mo.rth Day Year , <br /> F v! t c3 i ,1 i a Irl �` 11- 3 <br /> T 17 Tr(msporter I Acknowledgement of Receipt of Materials Map <br /> NPnnl � N kyr" L FgncsluT� ,. % Moyt D �ya ! <br /> S1 <br />'t P --_-- <br /> p IS Trunspa,ter 2 Acknowledgement of Receipt of Materials <br /> T Printed/Typed Name Signature Moaih Day Year <br /> E <br /> r;} R <br /> 19 Discrepancy Indication Space <br /> F <br /> ry A i <br /> 20 F(icility Owner or Operator Certification of receipt of waste materials covered by i is manifest except as noted in Item 19 <br />" Y —- -- ------ -- -- <br />�� Pr,r�tgA/TYPed Na{ria Morn ay � <br /> 1 � b�Gs3`H" Fs �a�iLli I <br /> 'i tg �s� "� TRANSPORTER #1 <br />