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t iA <br /> +s''t r <br /> C�"A%t�rL:.�.7�rv���.'k�t?�y•nt�'a`.'- it',�,�'"vx$i.. <br /> ALTA ENVIRONMENTAL SERiliCES.tIa <br /> 831 Davis SL <br /> �A tr�'nr r be F f 8pa/ �a CA 9Qi7�oV! <br /> p�vi is t!F s <br /> (SM 7942768 ; <br /> r` NON-HAZARDOUS U�pI AIC Cbl DoMarnifestent 2 Page 1 <br /> WASTEWANIFEST of <br /> M1 ,� a�ier�t�i Na4&i�tg Ailyh§g Address 16Q; ' ;- <br /> 6Q$ E Channell St <br /> s' i) .= 13o-{.,`55103 , Stockton , Ca 952Gj'i Stockton , Ca . <br /> 1 209 465--3609 <br /> 4 Generator's Phone( ) <br /> _ I <br /> Tror�y c Cfk, CT`�'°r�'Pnk-i ng 6 rd US VA Ip Number ( 4 d 8 ) 9 2 7-9 2�2 t <br /> 7 r Transporter 2 Company Name B US EPA ID Number <br /> r <br /> q, Dts ted Fa 1, n ,1e A dress 10 US EPA ID Number A Transporters Phone <br /> �� 'j O T l r C B Transporters Phone <br /> r 1 6 Fi a y r t! ra A C Facrh Phoa <br /> Jeri 4 rile Ga �Q7� 451-3276 <br /> ' <br /> k 1 I Waste Shipping Name and Description 12 Containers 13 14 <br /> - Total Unit# <br /> No Type Quoin Wt Vol <br /> s w, rl+- hGz6r4;Dua, 1-yal ro-,a r bon -1MPdCtea 011 , ACCEPT V 01165 18 ydw <br /> WEIGHMASTER CERTIFICATE <br /> HIS IS TO CERT$FY that the following described oamrsoddy was a+eighed,measured,or oounled by a wetghmaslar whose Wnature is on the certificate who is a recognited aulhonty at accuracy as prescribed by <br /> hapter 7(commencing with Seclion 12700)of Dunston 5 of the California Susinass and Ptoleesions Code administered by the Division of Measurement Stwidlards of the California Department of Food and Agneulture <br /> 13e r ill All i 1 ICKET NO. : 76780 <br /> ' r i 1 +,linty 1)L. VL Lt-)P,a 0 11t (.o. Df2iIE-. DCC 1, 19'm l s - 1 rj : 4 <br /> leLlit,L it is + + F1Ay R'j. VaCaA.? t 1 lis f ��. comincidI Ly, C -;TOIL . <br /> li r �} 1 •_ ,1 t 'ci.ca. L)tiiL L <br /> 1 ! F ' I• r �i F, f �y-I Jkl'ill.- <br /> i Totetl E'.1lilY'g@ : <br /> 1 C�� Tendered . {,iLE, Irl ft <br /> /! L.)la I-Ige .`r <br /> (f <br /> 1 Ft,�1t!,Pt (t+i) ilii t► » �,� � �r1r 1_t,�. <br /> ILO L iJt I iJiL LbE,. ! MLL <br /> g <br /> ri r 1 ,i+1 1+r , i�°R3Y��tc GNf'TU E J Y r a t t_.I, 14%1. DEPUTY WEIGHMASTER <br /> 16 GENERATOR S CERTIFICATION I certify the materials descnbed above an this manifest-ore su o federal regulations for reporting proper disposal of Hazardous Waite <br /> ` Signet Manch Day Year - <br /> rr rrtlr+ f'dl Lcalt�g /`1 12 i l <br /> Printed/TYFed Name <br /> `NI T 17 Transportar I.kknow ement of Receipt of Materials <br /> 2-1 <br /> N Punted Typed1 ame Signature 4y, - aDay <br /> / <br /> 5 10'1' <br /> y R 1B Trunsporter 2 Ac nowledge ent of Receipt of Materials <br /> Printed/Typed Name Signature Month Day Year <br /> E <br /> R <br /> 1 19 Discrepancy Indication Space <br /> F <br /> i 1 20 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted in Item 19 <br /> T -- - -- — <br /> Y - <br /> P inted/Typed Name Sig atare Month Day Year <br /> V7 1'9tlt y,��: f t Kai TRANSPORTER #1 �4� <br />