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50631 STOCICTONREWONAL WASTEWATER CONTROLFACIL" 80632
<br /> STOCKTON gWASTE H WASTEWATER T FORM
<br /> FACILITY WASTE XAULER MANIFEST FOAM
<br /> WASTE HAULER MANIFEST FORM
<br /> TO BE COlFLETED"WASTE IbVlERBEEOK ENTRY TG SRWCF. TO BE COMPLETED BY WASTE Hmx-nR DEFORE ENTRY TO WNCF.
<br /> PLFJrSE r'raa1TRWT wAar-0RLlyGBrsarKL KDI.{rT .. PL 9EPRINTANDPPESS [OI1 Cl�BtlIl FDRItl WTI.MOTs NL[p1®.
<br /> Waste Heulea C.mP.ay N.ma Vbrid.Capadly game HsINI QW�My'I'NII'9 �7 vaM]. �T7
<br /> valise L1oam.Na//,gfO L Daee f-?�7S"a Lww A 1 VdrJe LJmge NG.`l�l9�m n_nw Xar Ems'JL' coed E
<br /> C plrn nary aeldflsa,".s W q.n"d.p .aara.(sy btrbu. A.Igaamn.hW In rlbImh d!u.a canlplwr rNSIA adbws,r,,a,�W wXly d m,m awrw(a)IMw.A.19 u m.rW'be dbb r.a nsao
<br /> ham.wit roust-IrvM 16. rppmerll lM 14eee—h aourow-trybep INa"a 1*�N•>Ka.IT Rwe tNe Ipur arrow.M sM Wsa..
<br /> r.prneerbtiVew 9 TVPw renE 9aartey.Iabd-II maa gun bur..lra.a N H.sr..ta
<br /> toed;.Dlcll edalli.nall mm.RendWnverllkillan will ya mlypnY SRWCF- Ind:in9dl ddNTEmlfhma•Rendorn wfHkMlanlHl nE mfOs ny S9WCF.
<br /> 1- 6 / 2.Hann: 1.Memo d 2.ilanr:
<br /> Ad6'eer Address A4dreaS lddraa
<br /> PMlee PNon.No.:f 1 paaw No:f )
<br /> ' Weds Type: OrwAl4. WTypo: 4e^bY m11,
<br /> Wade TYM Oaewy: dl. Walla TypoQ"�9M
<br /> 6rwa1a 5i - fknermr SRratue �' GerRnlPr9ylM.ae.
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<br /> WMln smdw.td,lk Nw Yee W
<br /> IMtlrin 90 drba efyYNy? Yw He inn Smntarl dty lydhd Y® WHMn Endtaa dh lTR.7 Y. Na
<br /> a Mrw: [Nema: a H.me:, A.No-::
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<br /> wda Type: fba.IMly eaE Wd TVW Ou."T- WMNTyp.: Grl.rld./ w woes Trw• wwdllr�ed.
<br /> Geawmu Slp,alvs C.rlirib$Ilw.sw &naorswo— GY m.sq E
<br /> ' Y AAI.P.N. DMa' Timer AM.P.M. GSN Ttr[N: Ali.P.M. D.W TIfiN'� AM.P.M.
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<br /> TpTAlfNA1NT11YTALL SatAawk WL TOTAL OOAIRRYyALL So11F.w1: ..
<br /> AlbaabN Weetr Typo:PbTe»pplkabk nunaes In apa:e PraYM.diWvR IY.Hies Genl.Wi�uType:PYnaypllaaEls namlaer ln.Gax Prw+Idad eMOSt
<br /> 1.Rnidenml Setmpe 2 Pb1Mb ioiae' 1 RofraPryll Greae InlMoeprr a.Spetlal❑kd+arpo'• �w'pWE. I�Pamde Tote['!Restaurant Grease h1Nr5Yaler A.SpecNl DXCfrYpa"
<br /> •s�p,ae.o e,rra orwcaw..eseNFwlm rm mapoas.lm w'aw slw m mad.
<br /> '$yaaaaa ad b npuima,eol loenm and re.w,nylee pps<.,shot Ce I+dcaKO. "A Speotl iLmma mruae r/a Vlaled rdaPpnN ay SRWCF M�adlxMpe la Ye,ad.
<br /> "R 9aedtl firma mu fK via'aHN all ala0'c+eM1 ev SR14C%!eras 05r1ag1 k,b•w1.
<br /> I,dre below named woe's hwlar,dechre anger pews!!,of ponN,That to nor bat el k e I M.aoarraW I�ae�I named waste'Wa,dodos order penalty of oerjary.Bel to V,a bust d my krondadae I here eme V.
<br /> my rrvnledg Y YPa.payroll.,M wow PI all unstss j b,I saw ryww b 2u .el a[Pe SAW'LE.I Wmar oaTlaia,
<br /> deWAedthe ype,cua�ery,a�V s�aruad all„measles ayh'wh MwredlRBtb015W8edal Ibe SgWCF.IfannerdwNra. under penally of Ke d 2.11 hwag paRonNly Inlormed.Y Ill Pinar,namM a agent,aoxap Ndfiaprpmty wins
<br /> enderperany al peryary_:Rmlwsa fwrwtnally lnTwm.d aY tlrC Pvna,orerrefs open!.orocapenhddao prpaarlr,Naae as wof,Spsrerekredob,oaaparany mon9eGpe,NM tl,e wa5laio ll A.1hr soentla,'sP[a4peryraaya.cain Na
<br /> Ilra wor l SP s racei 1.i nave pe a ewlydga.0 ..d p mso y Adho rsi IMtl.l wptage b gaesa,b in lne sa el a Spada'Parra"r MMa�ra 0n 1d fs rel ei®eel periwala auwpnaed rmis.'Is per Prern...fu5ar[n
<br /> Ena�d�a�eTd gpebalanml[.Is rot handars aMdoes nPl eased prnpudy OdNpa2ad gib,aB pet WeaeaMenV$MrLa t',anlrelregriae'TWrya�rlb--,.I.Ifn dKbN,tander Plr4lry of Nyary,d,al lte mu'3 u•1tl leansponth�-,.or aasrme of yY
<br /> .r.,•ral roguroments.a alsodeeWre,under pewNy of peryary,tl,al H.W^.)..d la R.n.gM..waste was lrea dell m lera chardW�ad by bW w m ke raw yaMlO w afti w me Lme of said rise.Tam award or Lna wMiLmi
<br /> noste X cnalaeniew Cy as as a 1aaaruv>;waste or subslarru al Slf vee d gad tee. em award of flo mdihms drq redulrmerua d th.Waab tlw. Pami Aadhar.I prda s d the ra—10.[...[""P be Ilp abare
<br /> wH mgovenw�g d yp WaV,Hauler Pnm.. Fo,ta,-I dnddf l d Sat faiae b IeTW WLy Des'Ce r above infm,atm n Nil W wFq*y wise my Wr H rPemr.ardor eny.ppaav,SRWCF mgolaban,—V riot!In Vra
<br /> IrAdrnneon n fgbo.to wmply wdh my Waeb Heeler Pe M ardW wry pPi=lale SRINCF ragulafiP,may rMell in Iba nnrne.'A s•spenskn d ry Weals A.I.Prmh enerer dter Pen.MN as-y be alb J by law.
<br /> aamolmle w,ww"d my W�a/ste Hauler PNmb ands uw Do, EE tell,be ebwed by Isw
<br /> �^ a . ow wm WTN 7/
<br /> � ddergPa[SRWCF
<br /> DmpDub duwpnwSWC+ .
<br /> wavaNnlarsp,Ma,r.
<br /> Welsb HaleTa- p e aA p 1`— — nova n�asn.STCpa sYm, Re.w LIW,S
<br /> Oaaa,@aml>KTep! ,u31.., rbwp}sP,s
<br /> 80633
<br /> STOCKTON REGIONAL WASTEWATER CONTROL FACILTY 80634
<br /> WASTE HAULER MANIFEST FORM STOCKTON REGIONAL WASTEWATER CONTROL FACILITY
<br /> WASTE HAULER MANIFEST FORM
<br /> TO BE PLVED BY WASTE IWAER BEFORE ENTRY TO SRVlCF.
<br /> PLEASE PENT-D PRESS SNR0.M IIR ILLEOBLE f-0IINS WILINOf.B1F�[A��/f1� TO BE COMPLETED BY WASTE"MAER BEFORE ENTRYIpgRWCF.
<br /> WMN XwINrearrl NMnB yyII'' - V —y PLP�u RelBtwnlmF4r rftILLFY®.EIOr161aea Ktrr le,s/�
<br /> paI1lWslYanae rlP.�LDM. T K.y@ LYld.� WolkilsMr CaeePerWCaalydlY
<br /> Cwrrpido nARNr BddH N typo,and quemlty d waw.S Mp)bMn A.IprMrw aW be obWned hom. '1°MW laprnaa lM.l/yy�Ar1R-OMa n lf Key0 u 'af
<br /> raprHerrdtln Irr—h adore.,ndlylnp M."end qo.M"aN NNL R mare eren fear PParees In the waste Q000pNb n.nl..aldrwa.hTae.wed V rr y nr r..N—r.l.)below. A slynaarre 00-N aMnrW non,.
<br /> Isad;.Inab eddlllarNlfGmA R.ndem redfiu'port!!be madebY SRwOF. _ao,ruprs fromtreh eaerruS rarWybYMgPe gee.Ruanll[Y eWteQ Xrnom tMn rRar wurwa lnlM..rwr.
<br /> Nee;clad,rrdddoad foaa.RrradamaeXn�. wMhe ayda Dy sKwcP.
<br /> 1.Nana- zv 2.Nave: 1.NwIN' 'YLV 2 Na r
<br /> AdM1vaa: d Adbedr
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<br /> Plwa No{ PMM Nn:l 1 Rrpn.Nail R,me Xa.�I
<br /> WWa Tl----/-- Q'w'y MhsW Typo' Lil.aMln rMad.TYPa' WPsm TylAt 13rrrWF^I.
<br /> GMWw�ar'�g'wgar Gwwalp awl Gtterta 81pnMae, A�j tYneratar ByKNAPe=
<br /> Dab: �Thr- PlL OYw TwK------AM.PAT. Dab' _ - TaTaa• Cab' Thar ova.P.N.
<br /> WmYt SbCa,,m a\Y.en147 V. Bach 9l*-dy imw Y. lb 'wain 9tuinm dlr A t Ys Y/llyarS bor dry ba,bR Yn Na
<br /> a.N.T.: 3 Nanre- u IN
<br /> AWE— Am— -------------
<br /> Atldress: AdSe•
<br /> Pro tao.] k Plme I.: feioneN.4 Pkwr Na-f )
<br /> Ward.TlpG Owkw W. YYaW TYP: Oradh" as1- Was+.Type p,nrd4.,�a1 otia TYIW'. oa.ndly _
<br /> aanaafn sgn.bm: eewawsylaowr. c«�aa�� Dea.rceaslpraw:
<br /> DO*;_TXna: AM P.M. D TYrr. AMPV_ Dab T'M AM PM Date fts AM.P.M
<br /> ma.?NBhn swop—Ayll Y. .b WAhin SbGaY�oYy bell¢? Yea /,� Winln 51wY.1m tlly 1m11cT 1. r,o W,h g dy~ of
<br /> TOTALt2VMfTITY[ALLSWmp"-il2l C/}d nY TOTAL WANTRN(ALL Bwroay._��r�jpL
<br /> AIbWNM Wa.te Ph7.
<br /> spsa paMll.dWwa. fllRtndoneal Sepl¢yee�Pl 2.PtMabNTeir' ]L'F =ur'nn ealnkrcerylor G. I❑
<br /> 1 Rafld4a Wssftyga mappfie Toilet' ?Revb•Nanllyease MNriplor 4,Spada70edrafyg•• cro.;• Ndwp-
<br /> 'SI9rrNaa ra rrp m rpgaerr,dafaWr oriel ierpwwlMv preen YW b YrdcMoa. '>ATaNre+ar4 Oe rppalrec.anrefa.esaN eaera prsmawl a IrbtaaH
<br /> ••/.$pera/hwntn,w[eom'rerapd wY epproreeey EReY[F parwdeWlga la rM�arO .yrrM Ppne•rv#Oe naaOlndsM appew60Y SR1kCF lekara daTarye�s naoawa
<br /> I,rro balws nomad wave rtalna,dsr!•n ursNrpa,dry d prJrry,SNI DO we roar or.my 111M aara,a.y
<br /> I.Te helwv named waste luWn,dedar order penal.,or perryrry,Thal to Pe best d my knaadedpe here aarornWY asa=r,eM rlw doe.gvanury,all aaaee d W arse.atrUe I row agNa W d4Paaa Rr a!eqa�,I ka"dee4w.
<br /> I, o odd Bre type,qum;y,and.dace of ae wades by.1 r now re I I to d'Ispow dal fie SIT,Mp 17udlaer dedae, perury d pesryry,oral I w® H.na.d BN dwraw.mmar s
<br /> undo Oan.kl'dmrlmY.Vrellwp pWatra.ly a+kirm[d by NC P'a�ta,owner's egea.w OECarprlN oTlll prRWaYaNare [h5 wwsla was rflaplagdar M1.'v.lwlmY WIGwNdP.trdtlkwaele cmlalm m�YareleAeMiM sep[epe at r n p,e
<br /> OW, N&diL lrawe peasonal kraaaedpa.Itrd lh.g wav a lml ns h,rerde ml,septageor grease.IX In wS sa of a Speer Pwnit,N nollmmrr..edpw rot.la.wY vro.;wr+r wlacriena lmn..as u,emisauros
<br /> CR bdra3a.d.l Pwmit'a ap MtYdevp and dom raplayneed ore•IMly ayll�;iad tirr:te.as nr F,wTMoa4,renUsww caard raaa.rer0" Iabele�armdy d good he waal:aaaa boo Nell
<br /> Canbd la.lexidedare.trder PaMR. airf,sY.Ynlure VugrlcV rreea to Car,
<br /> repirmen pmwbydpeaAvy,Drat Na rode{s)usedb Vaepnl Nle waste was trap Pfal dargadpd by aaywaNmrdan wash orwhslwoe al lne emP of saw use r reMd•e rontllbra
<br /> mdwSEN dwaoarvsd Cy Ian as a haaxtlne wa®atx aebsarcas Y the ume of saltl 18e.I am swam d the enrrddons ad Ndurenwwp d Ca Warn".,A.Pwml[ Fudbar ianie,sland'.hat'aarw 1P a¢umy douraw Ps auor
<br /> rnd ragJ—"d M Wore.Nsulw P.w FV ,I aMrSlano ma[IalyrO p i—..y nmrnde ell aDev. w fNVa b rar.AA'wn my ayaate Hauler Permll anarar aiy app3calge SRWLF regalaton,pray rewlt W dre
<br /> Inlormeepn arr1rebrnrrply WN my w�leHwMParmladkY eery oppirabla SRrVCF mga , Mnwbd we IIrrTI.djMa wapaUbrl Olnry Yl[eelelieder PemM andfordrr peraNw as trot ba alpw.rl dy law.
<br /> ImmadNb sadP.rN:en d my WBSW Ranks PemW andbr pllm penaAlee as mar b alrYnad by .
<br /> Dearprm ' ' erdn / •d b eta m.rganaRWCP.
<br /> Deny Dell Id Tke /�lS ddwcharg.d SRmp 1MrW.NwW$grabN
<br /> W4sN Hauler 9grelur a it bpAaprwelegpsynY _ laae.ay Poaaee Yl.rk
<br /> OafuKrivaa5kYW u 9wwaa a'1Rdi
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