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/ON.HAZARESJSPECIAL WASTE & g STOS MANIFEST <br /> If waste is asbestos waste,complete Sections 1,11,111 and IV. NO. 512464 <br /> If waste is NOT asbestos waste,complete only Sections 1,11 and Ill. <br /> GENERATOR (Generatorcompletesall0sect1) <br /> ARCO STATION PRODUCTS COMPANY b. Generating Location: <br /> tnerator Name: 16 E. RARDING <br /> POB 5077 d. Address: <br /> (dress CA <br /> 90622-5077 <br /> BUEFIA PAR X, CA <br /> N/A <br /> (925) 29"-11891 PAUL SUPPLE I. Phone No.: <br /> tone No.: <br /> ner of the generating facility differs from the generator,provide: San.e as I(e) <br /> ARCO PRODUCTS COtdPANY h. Owner's Phone No.: TYPE <br /> wner's Name: <br /> C A 4 O S 0 6 1 0 9 9 <br /> TEE] <br /> 2 0 9 6 Containers L <br /> A DRUM <br /> DRUM <br /> FI WASTE CODE NON—RAZARDOUS SOIL k. 0uanti Units No. TYPE WSTIP BAG <br /> escription of Waste: 0 0 0 1mr RA <br /> LJ <br /> ON: I hereby cerfify that the above named material is not a hazardous waste as defined by 40 CFR Part 261 or <br /> UNIT <br /> GENERATOR'S CERTIFICATIged, <br /> any applicable <br /> regi ulationsaAND,ItthenwastereIsya treatment re Is due of passified and reviously sy re tricted hrazardous wastesubjectto the Oland Disposal Y -YARDS CUBIC-POUNDS <br /> app a q <br /> at ?Lhe' request AP.CO PRODUCTS COMPANY Y' -CUBIC YARDS <br /> Restrictions,t certio and warrant that the waste has been treated in Ccordance wh the re uirements of 40 CFR Part 266 and is no longer a M' CUBIC ME <br /> hazardous waste as defined by 40 CFR Part 261. I O -OTHER <br /> 1ELISSA KIRN/ DILLARD ENVIRON.' �/ ,. zla Shipment Date <br /> Si e <br /> Generator AuUwrized Agent Name s .z �*.,b <br /> #sl -a-o',a7iens �-limmlete a-`st s. _ti'�h. ':' ,� 7 -t ;t,�€ a„- <br /> ;,.,TRANSPORTER,.(GeneraRerap TRANSPORTERII m <br /> TRANSPORTERI <br /> DILLARD TRUCKING' INC h. Name: <br /> Name: <br /> POB 579 L Address: <br /> Address: <br /> BYRON, CA 94514 <br /> r_ 1 rIATSOQ j. Driver Name/Title: PRINTlrYFE <br /> Driver Name/Title: A PRiNrlrYPEq elI. Truck No.: <br /> 925-634-6850 a, Truck No.:� k. Phone No.: <br /> Phone No.: <br /> P)L%O�S C/4 m.Vehicle License No./State: <br /> Vehicle License No./State: Acknowledgement of Receipt of Materials. <br /> Acknowledgement of Receipt of Materials. <br /> 06 1 ° sh <br /> SM menl Data Dever S riaWre <br /> I menl Date <br /> Dever - r >ht= <br /> 2,* <br /> open` us (925) 447-0491 <br /> BFI — VASCOROAD SANITARY LF.NDFILL c Phone No.: <br /> Site Name: N. VASCO ROAD 4001 N -VASCO ROAD <br /> d. Mailing Address 94550 <br /> Physical Address: LIVERMORE, CA <br /> RE, CA 94550 <br /> Discrepancy Indication Space: ,TOBt 1007-111 <br /> I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> l p0$ 09-30312 <br /> Recelpl Dale <br /> Signature ° <br /> Na�a � , <br /> MENEM b. Shippers'S'Phone No.: <br /> . Shlppers's•Name: <br /> . Shippers's•Address: <br /> . Shippers's Special Handling Instructions and additional information: <br /> ...,.n ,,I;n„l,.enn1,ahla international and national governmental regulations. <br /> .ERTIFICATION: I hereby declare that the contents of this consignment are Cully and accurately described above by proper shipping name and are classified, package , <br />