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f <br />NON HAZARDOUS WASTE MANIFEST <br />PHYSICAL STATE: <br />RECEIVED <br />JUL 2 8 2014 <br />ENVIRONMENTAL HEALTH MANIFijSTT-NUM86'R <br />DEPARTMENT— <br />Tfp-- DATE <br />QUANTITY <br />E. <br />F. <br />G. <br />F7 H <br />WASTE DESCRIPTION: <br />GENERATING PROCESS: <br />SPECIAL INFORMATION: <br />THE GENERATOR CERTIFIES THAT lo <br />THE WASTE AS DESCRIBED 15 100% x <br />NON -HAZARDOUS. <br />r-7 Liquid <br />Ll Solid <br />TRUCK# <br />z A4vT <br />P/U DATE: <br />0 ransfN Lf. <br />M <br />—1230 E. Dumas Street x San Semardino, CA 92408 n (909) 889-5607 DRIVER 4 <br />M D.O.H.S. #0115 ■ EPA #CAT 080012800 jr <br />x <br />SPECIAL HANDLING <br />OR DISPOSAL METHOD <br />NAME DATE <br />cn X <br />0 ADDRESS <br />In CITY, STATE ZIP <br />PH. <br />PHONE <br />EPA NUMBER: x <br />QUANTITY AUTHORIZED AGENT <br />NAME <br />ADDRESS <br />CITY, STATE <br />PHONE <br />EPA NUMBER: <br />LIST COMPONENTS: <br />0 <br />M <br />A. <br />z <br />M <br />B. <br />C. <br />0 <br />X <br />D. <br />PHYSICAL STATE: <br />RECEIVED <br />JUL 2 8 2014 <br />ENVIRONMENTAL HEALTH MANIFijSTT-NUM86'R <br />DEPARTMENT— <br />Tfp-- DATE <br />QUANTITY <br />E. <br />F. <br />G. <br />F7 H <br />WASTE DESCRIPTION: <br />GENERATING PROCESS: <br />SPECIAL INFORMATION: <br />THE GENERATOR CERTIFIES THAT lo <br />THE WASTE AS DESCRIBED 15 100% x <br />NON -HAZARDOUS. <br />r-7 Liquid <br />Ll Solid <br />TRUCK# <br />z A4vT <br />P/U DATE: <br />0 ransfN Lf. <br />M <br />—1230 E. Dumas Street x San Semardino, CA 92408 n (909) 889-5607 DRIVER 4 <br />M D.O.H.S. #0115 ■ EPA #CAT 080012800 jr <br />x <br />SPECIAL HANDLING <br />OR DISPOSAL METHOD <br />NAME DATE <br />cn X <br />0 ADDRESS <br />In CITY, STATE ZIP <br />PH. <br />PHONE <br />EPA NUMBER: x <br />QUANTITY AUTHORIZED AGENT <br />