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x •&}>;uc„IF*:w<^C'�1�, 52s i e,- <br /> sALTA ENVIA4NMFNTAI,SERVK.ES.INC. <br /> j'Y1L..9Y y9yY t <br /> (W%_I 704-F!W <br /> 1 Generator's US EPA ID No T7%;Iesf 2 Page 1 NON=HAZARDOUS Not hpplicabl r- nt Na <br /> 'WASTE MANIFEST °f• <br /> 3 G nerator's Name and Mailing Address <br /> k�„ fY� ic _�:E, I _LEiaSir.g- 1649 E. Channell St � <br /> y N r_ Bu,i 55103 , Stockton , Ca 95205 Stockton , Ca . <br /> 209 46S--3609 <br /> 4 Generator's Phone( ) <br /> Trans oiler 1 om an Name 6 U5 EPA ID Number <br /> r I3 u� r' I- ruck-ing N /- A (40$) 927-932t I <br /> rr 7 Trunsporter 2 Company Name 8 US EPA ID Number } <br /> 9 Designated Facility Name and Site Address 10 US EPA ID Number A Transporter's Phone <br /> r ti zs++d i L a f t d f! I I 1 t!G 8 Transporter s Phone <br /> ell y .,J 2b h1a`r/ ROad �! / � C Facility's Phone <br /> ( 707 ) 451-3216 <br /> f <br /> r <br /> 11 Waste Shipping Name and Description 12 Containers of 14 Total Unit <br /> No Type Quanta Wt Vol <br /> im <br /> Vhazardous hydrocarbor, Inipac.I eJ Sol I ACCEPT U 01 165 18 yci.s <br /> YPEIG1"siXR CERTIFICATE <br /> i1S IS TO CCRTIFY that the lollowing described commodity was wwphed.measured M Counted by a wesghmaster whose signah,re is on this eerilteale who is a rercognized authority d accuracy as prescnbod by <br /> ne pler 7(commencing with Sedan 12700)of DrAston 5 at the California Business and Proleasions Code administered by the Division of Measuiernent Standards d the Callomis Department of Food and Agriculture <br /> TICKET NO. : 76790 <br /> l i 2 t t hilt;' J)t�4 c IC)PRIe11t Ca. DArC: DEC 1, 1993 1� 41 -St <br /> tJI o I Ii, ,i_ IJ'AY €2t J. V} LLaV , 11(2, Ca C:cliTtin aU1ty .C-1,330IL <br /> ..1310101 ir,_,i I 'i 3f-'t•/LJn1#: : ' <br /> 4,i t Ei I 1`4U i it 14(j, I IqkZrki,l�J I <br /> Total Chet-ga . <br /> f , ( l endered ; 1*l4t Vtel <br /> {1i5� lit LI t1r0vio Change : x,1b. "140 <br /> f /' #;1011441 (111 (,r uti S kc 1 LlIlt, L_b <br /> I o I a lit itllil 1_4m�. <br /> LflfdilY HALL <br /> ilii,, 10t1ct '(:Dr�� ctD -I -E3L . ) r iIl_€( 110, It1tiL� r]EPUTYVYEIGIiMASTER <br /> i <br /> u� % -- i <br /> Ier Ponied/Typed Name SignatuMonth Dar Year <br /> re / <br /> ` . Jt i tor odic! rat t_� sll-.c) zu 2 ] 3 <br /> �_ryt <br /> R 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> "21"d1 A Printed Xy p�l pr Signature M nth Da/ <br /> � N <br /> r P — <br /> 0 18 Transporter 2 Acknowledgement of Receipt of Materials <br /> "t T _ _ <br /> -Prinled/Typed Name Signature Month Day Year <br /> t E <br /> R <br /> p 19 Discrepancy Indication Space <br /> F <br /> A <br /> 1 20 Facility Owner or Operator Certification of receipt of waste materials covered by this manifest except as noted in Item 19 <br /> rr, Y <br /> Pr1,1ed/T ped NamS `S mire Da Year <br /> oyNei <br /> iK�t, Y ( s.sfilflwl-mf e3¢t�.Fi� i�ri,..iS�a�n � s�R r r 'N` , <br /> TRANSPORTER #1 <br />