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RDyUS'zSPEC1,lAL�W �x sS � n i �-, � `-1T" <br /> r ASE f- <br /> �. ..4 .•� 'W85te tS�� - e tmplete fectlons T. tV:t S's ��' ��.� Ci I �` � �? C <br /> a '�. -,_ - :,;�; > ., if waste Is C(01'.tisbestos waste,nomplete only Secti_Ons; and _ Q <br /> 1tODUCPB;OOPIpAgy <br /> u A)t00 BUT10N C <br /> &....�, b. Generating Location: <br /> PQB 5077 d. Address. 16 8: <br /> BUM PARR, CA 90622-5077STOCKTON, ca <br /> . <br /> gone No.: (925) 299-6891 PAUL SUppLE I. Phone No.: N A <br /> .or of the generating facility differs from the generator,provide: <br /> oner's Name: .ARCO EDUCTS COMPANY h. Owner's Phone No.:-Same:,8a I(e) <br /> WASTE CODE MA 40 S 0 6 2 0 9 0 2 0 9 TYPE <br /> Containers <br /> Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> .aoription of Waste: NON—HAZARDOUS SOILB -BAG <br /> k. 0 0 0 uanM' t�nits No. TYPE BA -e MIL PLASTIC BAG <br /> or WRAP <br /> O 3 Y 0 1 ED T .-TRUCK <br /> O -OTHER <br /> INERATOR'S CERTIFICATION: I hereby certify that the above named material is not a Hazardous waste as defined by 40 CFH Part 261 or UNITS <br /> /applicable state law, has been properly described, classified and packaged,and is N proper condition for transportation according to P -POUNDS <br /> ,Nlicable regulations;AND,H the waste Is a treatment residue of a previously restricted hazardous waste subject to the land Disposal Y -YARDS <br /> -trwt!Om,t tartly and warrant that the waste has been tre�a In ccordance the requirements of 40 CFR Pan 266 and is no longer a M' -CUBIC METERS <br /> .:ardour waste as defined by 40 CFR Pan 261: Of ARCO P Y' -CUBIC YARDS <br /> �. O -OTHER <br /> enerator Authorized Agent Name Sig re �6Npmers Data _ .. <br /> b - � <br /> TRANSPORTER I TRANSPORTER II <br /> -OUJ ARD TRUCKING, INC. <br /> me: h. Name: <br /> ,7ress:` tf3 579 <br /> i. Address:. .. <br /> *,CA 94524 <br /> rerNarneRitta`a fa% �-- <br /> PRWnYPE -a•' Driver t�81rIQ�[[tie: r' , <br /> 925-634-6850 � PwHrm�E <br /> .rte.No.: Ga. Truck No.: k Phone No.: - I. Trude No.: <br /> ,ide license NoJShater O `"1 i b m.Vehicle License NoJState: <br /> ato Medgemen^of ipt of Materials. Acknowledgement of Receipt of Materials. <br /> n. <br /> �re sni mant Date <br /> Drlwr naNNra <br /> sNpirerd onto <br /> €Sn)rAioive at <br /> Name: BPI — VASCO ROAD SANITARY LANDFILL c. Phone.No.: (925) 447-0491 <br /> cal Address: 4001 N. VASCO ROAD d. 4001 N. VASCO ROAD <br /> Mailing Address <br /> LIVERMOP,E, CA 94550 LIVERMOP,E, CA 94550 l <br /> i <br /> ,epancy Indication Space: - <br /> eby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> JOB# 1007-111 <br /> I ' <br /> GAS=�Agwt SignawreRecei� PO# 09-30312 <br /> " `4 ;'[ 7 _ _'n ryq.,� Due <br /> s'`� <br /> , SEES oaterators Me<eaa.r:astlpcar}sa!p �; " ,.-.:..- s <br /> pers's*Name: b. Shippers's*Phone No.: <br /> pers's*Address: <br /> i <br /> pons's Special Handling Instructions and additional information: <br /> 11 <br /> ICATIO N: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packaged, <br /> and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national covernm2ntal <br />