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kt��3i!�=� k ,4'++ 3'��de�t' � (��„2'`rl'•^�{• 4A {x. , r�" Ises r�sompieza-. A18 a ' :.': i tf waste is asbestos utiasta,templet@'Orth'S1tCtioitis T,U v..>d . :._dpp etes:_,_,p aRgo '> e : ate{ *N932 "stator Name: b. Generating Location Address POB 5077, d. Address: 16, $.' BARRING SUL+`M BARP.t CIL 90622-5077 Phone No.: (925) 299-8891 PAUL SUPPLE f. Phone No.: NIA a twiner of the generating facility differs from the generator,provide; - 2 Owner's Name: ARCO PRODUCTS COMPANY h. Owner's Phone No.: SETT aalI(e) - - TYPE BFI WASTE CODE C A 4, MOS 0 6 1 0 - 9 0 2 0 9 Containers DM METAL DRUM _ DBP _PBA�TfC DRUM Description of Waste: NON–BAZARDOUS SOIL - k. QuantitV Units No. - TYPE BA +6 MIL PLASTIC BAG L_L_LJ LJ LTJ or WRAP 0 0 0 Y 0 1 T T -TRUCK O -OTHER GENERATOR'S CERTIFICATION: I hereby certify that the above named material is not a hazardous waste as defined by 40 CFR Part 261 or UNITS any applicable state law,has been property described, classified and packaged,and is in proper condition for transportation according.to .P-- POUNDS applicable reguhations;AND,If the waste is a treatment residue of a previously restricted hazardous waste subject to the land Disposal Y YARDS Restrictions,I certify and warrant that the waste has been treat9d the requirements of 40 CFR Part268 and ism longer a M'_'.•CUBIC METERS hazardous waste as defined by 40 CFR Part 261. / • Ys _-CUBIC YARDS AROO I O -OTHER MNSd SSA KIRN/ DIT-LARD - - Generator Authorized Agent Name Sig t e Shipment Dale 2Ct10(1 TI'- '+'" ' , ,<"f"RANSPORTER "(Generator complete a-d, 7iannspo7 eicorrt u ,pheUiV tete - TRANSPORTER I TRANSPORTER H DUAARD TRU=*** DX.Name: h..Name: Address: POB 599 I;_Address: BYRM, CA '94514 f Driver Name/rte: _ - e �.,.._..,�..�,,.. 1 !hqr 925-634-6850 P'UNTrff Phone No.: n e:Truck No.: Z k. Phone No.: I. Truck No.: Vehicle Ucerlse No./State:—SpfJ� /A m.Vehicle Uoense No4State: Acknowledgement of Receipt of Materials. – Acknowledgement of Reoelpt of Materials. 1 � q � n Daver Sionature Shimnent Date Dinar Si naWre Sh me tDete - >2C(IOtI:.III r'k• { ;ESTINATION, eneratorcompletesa-d desfination . Site Name: BFI – VASCO ROAD SANITARY LANDFILL c. Phone No.: (925) 447-0491 . Physical Address: 4001 N. VASCO ROAD d. Mailing Address 4001 N. VASCO ROAD LIVII2MORE, CA 94550 LIVffitM12E, CA 94550 . Discrepancy Indication Space: I hereby certify that the above named material has been accepted arNUO the best of my knowledge the foregoing is true and accurate. e3 W JOB# 1007-111 Cj POO 09-30312 Name or Authorized Agent SldnaWre, -..=.Q it _ Receipt Date 3ectlon IV ASBESTOS (G eneratorwmpletead i g Sh ppe co,*.tes e) . Shippers's-Name: _ "b. Shippers's*Phone No.: . Shippers's-Address: . Shippers's Special Handling Instructions and additional information: :ERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packaged, Larked,and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.