Laserfiche WebLink
ALTA EH AI.SERVICES INC, _ <br /> M am Davis St <br /> s '61`rs xr Y CA 93587 <br /> " NON-HAZARDOUS ' GTg5'ear)k'0 Fit 1D�b I DocumentsN. Page ' <br /> WASTE MANIFEST <br /> 3 f,,je0prcvc's Vor�eoar�a Address _ <br /> ,r ^�'i�' 1649 E . Channell St <br /> 8on 55103 Stockton , Ca 95205 Stockton , Ca . <br /> 209 465--3605 11 <br /> 4 Generator's Phone <br /> f[ ) <br /> Q� $I Tran;pq tf C F i gonl PM-k is e' 6 [.i uP Er ID Number a C) 927 <br /> —9321 <br /> 7 Transporter 2 Company Name 8 US EPA ID Number _ <br /> 3 9 Desl ed Faci i N d to Ad r ss 10 US EPA 1D Number A Transporter's Phone 1 <br /> 1~ .,,FZj j L r� � 1�1 , QTc <br /> tJ 'b Hay Ro.—;sd Fa F3 Transpo�rtpergsgPhone <br /> C Facdlt�r'!� 1) 4 5 1—3` 7 6 � <br /> tra L ! <br /> ie <br /> 11 Waste Shipping Name and Description 12 Containers 13 14 <br /> ' Total Unit <br /> ' No Type Quantity Wt Vol I <br /> r a1 Tt= h�z�f csL; f� I'ydr��c�lr cis -impa,:.t�J „C'' T 1 , ACC EP 4 0111 5- -- - Ifs yd <br /> s <br /> WEIGHMASTER CERTIFICATE <br /> HIS IS To CERTIFY that the toAowrtq desicri ad corrrnodtty was weighed measured or counted by a weghrnaster whose signature b on the cerld"te who Is a ized out"of aoGuracy as prescribed by <br /> Chaplet T(commencing with Seciron 12700)of Division 5 of the Calilornia Business and Prolessions Code administered by the Mislon of h%asuramenl StartclarAs at the Caltonda Department of Food and Agriculture <br /> T _ <br /> LEVAIIlrliwlUIlk r PTCKE. t NO. 76720 <br /> 11`1 �,rlfif y Gevelopment Co. DATE: DEC 1, 1993 $4n : A,, <br /> I16� 111-11 Cl Irr C 'IL_( Hay Ru. Vacavxl le, Ca. 'Cori mod ity :C--.SOIL <br /> 111;11 ; E j I 'rIcra UnILt : <br /> P+,lt f J:y a I I.[ l /Ij / -1 of al Ch'Ar-ge <br /> ! f I ender-eco <br /> r-)5C.=') , 0111 V) Change ; Lu3u +,Il�I <br /> rr, <br /> �1 <br /> /5480 114) (7)r WI Z 11L I tjlrt l_t1�. <br /> af9 7oJ 1 CLI k' W-' i III It [ Lt.. <br /> 7 R 0 ilE1 4Wt' 1 ',ht LL, . CANDY HOLL <br /> h t_lt_k i 4 o 1311 DEPUTY WEIGHMASTER <br />: 16 GENERATOR S CERTIFICATION I certify the materials dexo6ed above an this manifest areat lent to 5jowitil regulations for reporting proper disposal of Haxordous Wmie { <br /> .L Punted/Typed Name Signature Month Dy Year t <br /> I L I re l- t�f 'i'a f a 1_sea 1 =� // f ���1/ 12 X2 1 c1 I <br /> I I <br /> r T 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> APrinted/Typed Name SignatuMonthh• Day Year <br /> AT8 Transporter 2 Acknowledgement of Receipt of Materials <br />"l T Printed/Typed Name <br /> rpt E Signature Y Month Day Year <br /> di f1 <br />,n <br />=t 19 Discrepancy Indication Space # <br /> F <br /> air I 20 FpJlly Owner or Operator Certification of receipt of waste materials covered by this ndest except as noted in Ite 19 <br /> T <br />�E Y --� --- -- q nr y <br /> Printed Name <br /> SiSig <br /> Aa <br /> Esti \ <br /> r <br /> graI "J�1'3; 1rei'risS y;� foil <br /> Flfy � kAt ¢ TRANSPORTER #1 �1' ' <br />