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-NAZAR SPECIAL WASTE & <br /> BESTOS MANIFEST <br /> if waste is asbestos waste,complete Sections I,it.III and IV <br /> If waste Is JJ_Qj asbestos waste,complete on S <br /> N ections1,Rand lII. No- 512456 <br /> GENERATOR `la <br /> lneratorrNameARCOIPRODUCTS COmitn", <br /> Jdress POB 5077 b. Generating location: ARCD STATION 3x04932 <br /> BUENA PARK* CA 90622-5077 d. Address: 16 E. BAADING <br /> one No.: (925) 29 'tIV 1 PAUL SUppLE STOCKTON, CA <br /> -at of the generating facility differs from the generator,provide: f• Phone No.: N/A I <br /> 'nets Name: ARCO PRODUCTS COMPANY <br /> h. Owner's Phone No.: Sazitel as I(e) <br /> WASTE CODE C A 4 0 5 m30 9 9 0 2 9 6 <br /> Containers TYPE <br /> L•dption of Waste: NON—BAZARDOUS SOIL DM•METAL DRUM <br /> DP -PLASTIC DRUM <br /> k. Quant' Dns No TYPE B -BAG <br /> BA -6 MIL PLASTIC BAG <br /> 4ERATOR'S CERTIFICATION: I hereby certi D O D O N O 1 T T -TRU <br /> or WRAP f <br /> applicable state law, has beendescribed the above named material is not a hazardous waste as tlefined b O -OTHER 6 <br /> koble regulations;AND,If the este Is a . Gasified and by CFR Part or orUNITS <br /> pip <br /> treatment residue o packaged, and is in proper condition for transportation according to p i <br /> rktions,I certify and warrant that the waste has been a ad a previously restricted hazardous waste subject to the Land Disposal y <br /> rtlous waste as defined b accordance with the -POUNDS <br /> Y CFR Part 267. . es Of�ARC O PR 4D CFR Part 268 and is no Ion era -YARDS i <br /> SSSA KI,N/ DILLARD �' %! ADDUCTS COMPANY g M' -CUBIC METERS <br /> razor Authorized Agent Name ENVIRDig j Ye -CUBIC YARDS <br /> Sig?ature O G D -OTHER ! <br /> i Shipment Date <br /> kII , .3 r..<< TRANSPO <br /> TRANSPORTERI p I <br /> RTER �Generatorcom leve-". Ti1 <br /> 11 <br /> s1! p 1 Plefe hen <br /> DILLARD TRUCKING <br /> + INC.INCTRANSPORTERD <br /> .s: <br /> PDB 579 h. Name: <br /> BYRpN+ CA 94514 L Address: <br /> hu lit,I tle: 1# <br /> 9z5-634—baso J r n-oC <br /> INr <br /> Jo.. 1 n 1. Driver Name/Irye:-. t' <br /> � � � e. Trude No.; -/L't k. Phone No.: PFUNrmpE t <br /> License NoJState: /"t �/u�f2 1. Trude No.: <br /> Aedgement of R m.Vehicle License No <br /> ^ pt of Materials ,/State: <br /> Acknowledgement of Receipt of Materials. <br /> if —zMent Date n i <br /> DESTINATION <br /> BFI VASCr) ROAD SAN (Ceneratorcompletes8 �. ''on she completes a-L) sn� -a-1 nate <br /> a: ITARY LAND_'ILL <br /> tddress• 4001 N, VASCO ROAD o. PhoneNo.: (925) 447-0491 <br /> LIVERMORB, CA 94550 d. Mailing Address 4001 N. VASCO ROAD <br /> =Y Indication Space: LIVERMORE, CA 94550 <br /> <rtity that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> JOB# lOQ7-111 9 <br /> i POP 09-30312 <br /> Receipt Date <br /> i <br /> I, <br />