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ALTA-EN_ YIa4NIENTAL 9ERVLC3,iN -- - - - - - -- _-_ -- <br /> 831 DAvW St - <br /> Vacavdl%CA 98887 <br /> (SW 794-2T88 <br /> ' NON-HAZARDOUS` I G erotor' US EPA ID No Document !2Pag* <br /> WASTE MANIFEST �[' t i~Pp 1 Cable <br /> 3 er s a e and Marhn Address n <br /> P1�ii" eas�lrt� 1649 E Channe 1 'I St <br /> P 0 BOA 55103 , 5tockLon , Ca . 93205 Stockton , Ca - <br /> 409 465-3609 <br /> 4 Generator's Phone( ) <br /> 5 Tra orter 1 Cym a Name 6 US EPA ID Number 14- <br /> f. a <br /> eu�f' I� `�`rUC1, ing N / A (408) 927-9321 <br /> j7 .Transporter 2 Company Name 8 US EPA ID Number <br /> e " <br /> 9 Drslgngted fayhtl Norp pool lite A I ress 10 US EPA ID Number A Transporiefs Phone <br /> C2 f Q ` L L�l Q I ` 8 Transporter's Phone <br /> ?6 113t <br /> All L>r C i'f l ) l�, �Ca C Facdltlls Phone I <br /> ( 707 ) 451 -3276 <br /> 14 <br /> I 1 Waste Shipping Name and Description 12 Containers Tot13 <br /> Unit <br /> No Type Quantity Wt Vol <br /> I <br /> `Nfjo- hazardcUS hvdrocarcn IMPactiE--d Sail. ACCEPT _ # 0115 --- -- �18 yds <br /> WEIGIf USTER CERTIFICATE <br /> S IS TO CERTIFY that the folowiry dmnbii9 oantrrtodllr was trrefyltad measured a camtad by a welgtrnaster vrtsoee nature is on this certificate who Is a rtscopnrzad authority of accuracy as prescnbed by <br /> =peer Y(comrrwe ting vAlh Section t2MO)of Division 5 of the CaNlxnk Bustrsess end Profsesgns Coria adminnlerad by the bion of Meesumment Standards of the California Department of Food and Agriculture <br /> t , <br /> C`7 <br /> I 1t11iritwr Lir': -FICKET NO. : 7660 �] <br /> t}evc 101111leitt, Co. UAIL: DEC 1, 199.3 15; lbs :f.. v, <br /> r.lirc111 1�1 E, „'() tirs1r Rd. Vcf�ciblllay Coif. Contmadit, y :C--SOIL <br /> t11 `III . 1':1-. / /} rrI xc_ /Unit <br /> {1 I I> 1 l t+' 1 11/rtii-i13 t k(JRL ISI j <br /> ,;l 1';li' [ CI RLL i Total Charge : <br /> Tender-ed: Id. 143 vi <br /> c31_I ,+, li ► L , 9 681 0001-1 Change : ill. 04rk <br /> 1'_I L I b-, <br /> Gi c1� ,1 (� r crtli Il.�fb . <br /> 1)L r r'C7 (�C 1, fjI1t (_(3S. <br /> :WAI,v HALL <br /> �.�pT�1 <br /> Fi t�c i t , :i i IS ILt G I E7E DEPUTY WEIGHMASTER <br /> r <br />'j 16 GENERATORS CERTIFICATION I certify the moteriah described above on this monifesi are not s c o f regvlahons far reporting proper disposal of Hazardous Waste <br /> Da f Pne,ted/Typed Name Signature / Monih y year <br /> 1.1 1 it C,11 Leas-jr,D312 lj1 111f <br /> T 17 Transporter 1 Acknowledgement of Receipt of Materials <br /> I q Pnnte d/Ty Im nat. �T Month Day <br /> L �.. <br /> p18 Transporter 2 Acknowledgement of Receipt of Materials <br /> 7 KT Pruned/Typed Name Signature Monih boy Year <br /> R <br /> 19 Discrepancy Indication Space <br /> F <br /> a 1 20 Facility Owner or Operator Certification of receipt of wale materials coveted by thi manifest except as noted in Item 9 <br /> T <br />' r„P�mrodJTYPed Na e� SlMoarh oy Y � <br /> s�rfk �' L1 rill if l f 4 1 S9r7l a <br /> LO <br /> TRANSPORTER #1 �� .I�t:�ls <br />