Laserfiche WebLink
NON - HAZARDOUS WASTE MANIFEST <br /> • D <br /> z PROFILE NO <br /> 11-800 458-3036 <br /> / ❑ BAKERSFIELD ❑ YOLO ❑ PHOENIX <br /> NOTE: This form to be in lieu of the Toxic Substance Controls hazardous <br /> waste manifest To be used for NON-HAZARDOUS WASTES only <br /> •....y wr wr..r.•v�..'....r..�..w.r.+.r.ti.•r.+....r rr.+..ti...r r...w.wr�r rr.rr nrr�.r+r�r�...�r wr w..+.r.r rrr ti•.+r•+r w..ti ti n`►r.�'.r wr.+..rr/ <br /> t <br /> Name MR. ROBERT FOWLER <br /> T. <br /> O Mailing Address 1211 S. TURNPIKE ROAD <br /> Q STOCKTON, CA <br /> °C <br /> w City 1 State 1 Zip <br /> Z <br /> 209--463-4786 Contact • ROBERT FOWLER <br /> O Phone No o 0 0 <br /> m Signature z���✓-,�1 Date O Z <br /> LU THE GENERATOR CERTIFIES THAT TH ASTE AS DESCRIBED 1S 1001/9 NON-HAZARDOUS <br /> a <br /> Waste Descnptian 1�lQTORING WELL SAMPLING <br /> O Generating Location <br /> jr 1211 S. TURNPIKE ROAD, STOCKTON, CA <br /> U <br /> m Handling Instructions <br /> Quantity <br /> DO C ]BSL C K]GLS C ]YDS C ]TONS <br /> gONTAINER TYPE C R]TANKTRUCK C ]DUMPTRUCK C ]DRUMS C ]BINS C ]OTHER <br /> DESIGNATED FACILITY . <br /> NAME <br /> SEAPORT EWIRONMENTAL SERVICES ADDRESS 675 SEAPORT BLVD. <br /> CITY/STATE/ZIP <br /> REDWOOD CITY, CA 94063 PHONE # 650--364-8154 <br /> Cr. TICKET# °r z�� 3 TRACT1TRLR# -� 7 Zr' <br /> MP VACUUM TRUCK SERVICE s <br /> No "` <br /> O MP ENVIRONMENTAL SERVICES, INC. gin Bin Nos <br /> wr `�` <br /> CL 3400 Manor Street <br /> Z Bakersfield, CA 93308 Date - <br /> Q <br /> $05/393-1151 PIU DATE C7?_-- 10 o O —Job# <br /> I— <br /> Name SEAPORT E1%VIRON2 ENTA?, SERVICES Disposal Method : <br /> Address <br /> 675 SEAPORT BLVD. ❑Landfill Other <br /> r <br /> City/State/Zip REDWOOD CITY, CA 94063 <br /> < Phone No 650-364--8154 am <br /> Time pm <br /> ❑ Discrepancy <br /> Signature Date <br /> *rcnpj^Pq'1R—FR RFTAIN <br />