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ALTA ENVIRONMENTAL.SERVICES.INC. <br /> 831 Davie� St - --� _ --- - - - - <br /> F' X Vacalde.CA 9565'7 <br /> 4800)7aa-2768 <br /> enerator's US ID No Manifest 2 Page T <br /> }' NON-HAZARDOUS, Not App l icah1 Document No <br /> 1 Gof I <br /> r WASTE MANIFEST - i <br /> , er or's Nn a and Mailing Address _DGS <br /> c�' �a=1 �'�as 1649 E Channell St <br /> P 0_ ' Brix 55103 , Stockton , Ca 9520:., Stockton , Ca _ <br /> 4 Generator's Phone( 269 465-3609 <br /> i Tru outer 1 m a Name 6 US EPA ID Number <br /> f - auaI e UC 9nc N / A (408 ) 927-932 <br /> 7 Tronspo�rter 2 Company Name 8 US EPA ID Number i <br /> — • -.' _ µ - I - 1 <br /> q Designated Facility Nap art itte Address 10 US EPA ID Number A Transporter's Phone <br /> tr Cf f 1 Cl J La n c�r l I , 8 Transporter's Phone I <br /> �) l ?6 Hay Road N / A C Facility's Phone <br /> Vzicavl7le, Ca (707) 451-3276 <br /> 11 Waste Shipping Name and Description 12 Cantatners 1a! Unit <br /> No Type Tot <br /> Quantity W1 Vol <br /> 1� ,_,n- hlazardoUw hydrocarbon impacted z cIi1 , ACCEPT # 01165 18 yds <br /> -- l - <br /> WEIGHftiIASTER CERTIFICATE <br /> HIS IS TO CERTIFY that the folowesg described torwnodRy was we measured or courted by a ssergtxnasler whose signature b on this cang"le who Is a reccignlced auffiordy d accuracy as prescnbed by <br />:hapler 7(commencing vnlh Section 12700)d DMtt3on 5 d the GIdomia Business and Rdessions Code administered by the-Dwssion of Hleasurement Standards of the Gldomin Department of Food and Agrcutture <br /> t�4 7sllrrr <_t<a( t r•• l ICKET NO. : 76777 <br /> r1 z ( rrtTll y I L- 'C10f)HIf'tlt CO - !]M E. DEC 1 , 19')3 1r : 4`,:0.-_ <br /> C xl,l ,t If lu t_. f_% Hay Rj. Vacaville, Fa. Comm, odii.y :C-SOIL <br /> -Total Charge : <br /> -r end or,ed : $0. I10 <br /> '+1'+=si t'r 11 Lit_ , 9 +r 4 �� Change : AJO- k tr <br /> 7`0 01) (it u- 0_ 2tii1t Lbir . <br /> 11V L I _Jf l L Lt}t� . HORY BORDEN <br /> /DRIVERflG"Tuek DEPUTY WEIGHMASTER <br /> 16 GENERATOR'S CERTIFICATION I cattily the materials described above on chis manliest are not .a to eral regulations for repomng proper disposal of Hazardous Wast* <br /> Printed/Typed Name Signature - Month Day Year <br /> �y <br /> r,_,r A l d ( ,31 Lea5irt� I <br /> ' i <br /> T17 Transporter 1 Acknowledgement of Receipt of Materials <br /> N <br /> A Panted/Typt ame Signature Mpnfh, DaiA.L. <br /> N �o'1Q. L4 5--e– 6 ,- <br /> S <br /> P <br /> o 113 Transporter 2 Acknowledgement of Receipt of Materials <br /> R Month Da Year <br /> T Printed/Typed Name Signature Y <br /> E <br /> R <br /> 19 Discrepancy Indication Space <br /> r <br /> F <br /> A <br /> 20 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted in Item 19 <br /> 1 <br /> T <br /> Y <br /> Pnn Ty d me ��� _.y J � / S riot � �op(h Day Y o� a <br /> i f(/yl! G /ff (// <br /> M <br /> a rownMEM.Mi <br /> Lr i�: c TRANSPORTER 41 <br />