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r is 7sri JS.♦lir' � s ' �' Yi <br /> ALTA ENVIRONMENTAL SFAIiKWA INQ__ - - <br /> '� bP 831 Davis St , <br /> Vw avg*CA 95887 <br /> (ON)7"2768 <br /> NON-HAZARDOUS I Ge Not`'ASpllicable DocumentNo2 PagefT <br /> WASTE MANIFEST of ` <br /> 3 Generators Name and Mailing Address 1549 E, Channell S t <br /> MIL' Call " Lea5ln4f <br /> t� Bd,'--5'5 1 03 , Stockton Ca - <br /> 4 <br /> a _ 95205 5tacktnn r Ca . <br /> 4 Generator s Phone{ - 465-3609I 65`'lip <br /> 5 Transporter 1 Company Name 6 US EPA ID Number ' <br /> t E,suar irr frur-king iv / A , (408) 927--9321 <br /> 7 Transporter 2 Company Name 8 US EPA ID Number - <br /> 9 Designated Facility Name andSite Address 10 U5 EPA ID Number A Transporter's Phone t <br /> L arid J L.G I-i d f l r t I l r 1 t i c B Transporters Phone <br /> r� 1 'b i-iraV ROad N Q C Facility, <br /> 1n< env it ke . C.�s Facility, 451-3276 <br /> 11 Waste Shipping Name and Description 12 Contamertn 14 <br /> Tot <br /> al Unit <br /> No Type Quantity Wt Vo! <br /> ° I;, „r itraz r dosis hydt•ocarbon 7 mpacred o l i , AC( CPT # 0 1 1 65 18 yid <br /> v�lghsV ytll~JIGHMSTER CERTIFICATE neo-�I <br /> pier 7(c mirnencing with Section 112700)of DrAsioon 5 of the Caklwnla Beane and Professions Coae�a�matered by the rip lston d Adeps mment Standsrds o1 the Ca1Yoocnla Departr°trsent(A FF000d wicl Agncbulu re ! <br /> z <br /> r , <br /> TICKET NO. : 716771 <br /> 1 -i ,atlllty <br /> DATE. DEC , 1 t 199:3 ` 12: 2 3 :01 <br /> D vej apm nL Co. <br /> klny CaIII luodtty :C--S131L <br /> '1111 I 1'�>", / F`r'1C�/LJTllt <br /> L11i ` il'1Jit Iit +la ' IL)RCIIL <br /> sl �,, 1U f r� s i RE t_ I Total Chas-�ge: <br /> Tend eI^ed : $tA. trik'I <br /> Sif_E i+r i t i s7 \ 3�E L� r IziSjil�lt�1 Charge : <br /> t ' <br /> L.ltr ,F LII tt ,`s <br /> t <br /> 3lliok7 h1) Cal cl�L tjw 1 [list L bs'. <br /> I"s»t l c_ [1, d lilt. I LIS. <br /> C0 I'AuL WcE 3 kitt Lbs. M RY BORDEN <br /> T1 i t l�,i l l t l : 1, l RUIG WIT[Vt T 1 i t, I C I I t i. r 1 f DEPUTY WEIGHMASTER <br /> 16 GENERATORS CERTIFICATION i certify the materials described above on chis niondest are not to reputotrona for reporting proper disposal of Hazardous waste KM <br /> Prinit d/Typed Name Signature %4G Monrh Day Year <br /> t-" l F of ttil 1 d Ca) L eas i rii-1 <br /> T 17 Transporter I Acknowledgement of Receipt of Materials T'\ <br /> qrimed/Typed Name Sig o Day / <br /> S "��r J`�C ��ffrrii �/f <br /> y p 18 Transportif 2 Acknowledgement of Receipt of Materials <br /> R — Printed/Typed Nome Signaturer <br /> Month Day Year <br /> E <br /> R <br /> 19 D,serepancy Indication Space <br /> n <br /> iI L <br /> 3 <br /> L 20 Facility Owner or Operator Certification of receipt of wa,te materials covered by this on,fest except as noted in Item I9 <br /> I <br />' T <br /> iy ----`W <br />! PnrljrjUTyped N o $ignatur M*nlbLo <br /> 0`, ,� MINN.` <br /> 1' t TRANSPORTER #1 <br />