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ALTA ENWONMUL SFR111=ttVC. ;I <br /> Y r <br /> 831 DavtS St.Vwav"CA 9W <br /> � y <br /> 4 # (800)7"2M <br /> I <br /> ` `�fx NON-HAZARD�US� 1 G er tar' Us E ID Na Manifest 2 Page >I <br /> f0 1 p p�l C a b l e Document No of <br /> WASTE MANIFEST <br /> 311ei`}°r�°tyf�O�e� 5 � is Address 1649 E . Channell St <br /> 1 �s I <br /> p t; ;5103 . Stockton , Ga 9524,3 Stockton , Ca . <br /> 4 Generator's Phone( 209) 465--3549 <br /> c. t S IJU EAPA ID Number <br /> S e " artNMCek7n <br /> (408) 927- 9321 ! <br /> 7 Transporter 2 Company Name 8 US EPA ID Number <br /> 9j Dekg8jedjacJqjprpTo j Site Ad�rre,, 10 US EPA ID Number A Transporters Phone <br /> CE 1 B Transporters Phone <br /> 64 2b F I a y K o e d r J / A C Factli 's Phonqq I <br /> vs :ave11e Ca . 707 ) 451 -3276 I <br /> 12 Containers 13 i <br /> ]I Waste Shippingr Total Un Name and Description j <br /> Unit i <br /> No Type Quonti Wt vol <br /> 9�.� i -hd;�rcJotfs h�Jdrocei,bon impacted X071 , ACCEPT It Q11E5 18 yds <br /> f <br /> WFJGHYASTER CERTIFICATE <br /> HIS IS TO CERTIFY that the tollowasg descrbed conirnoddy was weighed measured,or counted by a wergtrnaster whom signature Ys on this conlficate who is a recognized etd� accuracy al o�as pr wnbed b <br /> Zhapter 7(corn"noing with Sedion 12700)of Division 5 of the California Business and Professions Coda adnimstered b the Division of trlaasuremerd Standards of the Callomia <br /> Agriculture <br /> 1 <br /> I4f•itIli hictst t i TICKET NO. 76737 <br /> f 1 1 irittll, +� Duvk2 up.lellt: Co. U!-3fE: DEC 1, 1993 11 :01 ;2t <br /> z rIt i �J lei t fc_1 I Iris Rd. V-'Cc tv-. J 1 e, (:t C unit o a t .C---SOIL. <br /> (1!llll 1`r r Sit ICL�un1 t : <br /> f; 3r3 tt�tll. itlttt3t� 1+111 E (lt , <br /> -fatal. Charge : <br /> Tendered : <br /> lit tf f tt' 1 E t t_ , 9:�L•t� I�I�I' tI Change : W. I'lo <br /> �tlll ,r tai 1L,, ` <br /> (j, 1.rAnt L U5. <br /> l q vi 1, L h!. <br /> e+ lzi�� !lL-t, lt� I Lifts I_t�s. 1,siAg1j`r' HALL <br /> i i l l l i l t i l d : rt'5"y � lT� ft t tC_I 1 I o. i L7 DERIIY WEIGHAMSTER <br /> lb GENERATORS CERTIFICATION I certify the materials described above on this manifest are not wblel federal regulotions For reporting proper disposal of Hazardous Wane <br /> Printed/Typed Name Signatur '.i' <br /> r — Month Day Year <br /> /'l l W e t s J l Ir i 1 lJ l Cl I L e f t C j /' Ll I <br /> I r,I <br /> s T 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> a R $i natter M th Day Year <br /> N Pnnte Ty d N` � 9 � �f <br /> S <br /> P IS Transporler 2 Acknowledgement of Receipt of Materials <br /> R Printed/Typed flame Signature Month pay Year <br /> E <br /> R <br /> 19 Discrepancy Indication Space <br /> F <br /> 20 Facility Owner or Operator Certification of receipt of waste materials cove red by this onifest except as noted in Item <br /> t T _ <br /> Y _ - <br /> T &N Signal Mgn1 Dor r <br /> rf r�C tiL IP 1"ejij, .g .7 t <br /> :�t� i�,�� � �� it TRANSPORTER #1 � ' <br />