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NON-HAZA pECIAL WASTE & STOS MANIFEST <br /> (f rite, 0 to s Waste,complete Sections t,[bill and tv *' q I�J� , <br /> �ifwaste l�jQl 6sbestos waste,complete only Sections 1,Rand in. N o' 512 4 3 <br /> A. <br /> Generator Name: ARM PRODUCTS 'COtD'ANY ' b. Generating Location. ARCO STATION #04932 <br /> Address POB 5077 d. Address: 16 -E. e'ARDING <br /> DUENA'PARKe CA 90622-5077 STOC&TOA, CA <br /> Phone No.: (925) 299-8691 PAUL SUPPLE f. Phone No.: NSA` <br /> owner of the generating facility differs from the generator,provide: <br /> Owner's Name: ARCO PRODUCTS CONII'ANY h. Owner's PhoneNo.: Store-'a8 I(e) <br /> Bfl WASTE CODE <br /> C A 4 0 5 016 1 .117, 9 10121 1 0 9 Containers DM-METALL RUM <br /> DP -PLASTIC DRUM <br /> - .. B -BAG <br /> Description of Waste: NODI—BAZARDOUS SOIL k, Qu units - No. . TYPE BA -6 MIL PLASTIC BAG <br /> or 0 0 0 0 1 TT T -TRUCK <br /> O -OTHER WRAP <br /> GENERATOR'S CERTIFICATION: I hereby certify that the above named material is net a hazardous waste as defined by 40 CFR Part 261 or UNITS <br /> any applicable state law, has been properly described,classified and packaged, and is in proper condition for transportation according to P -POUNDS <br /> applicable regulations;AND,if the waste Is a treatment residue of a previously restricted hazardous waste subject to the Land Disposal Y -YARDS <br /> Restrictions,I certify and warrant that the waste has been t n accordance jh the requirementaof 40 CFR Part 266 and is no longer a M3 -CUBIC METERS <br /> hazardous waste as defined by 40 CFR Part 261. Ue Of ARCO Ys -CUBIC YARDS <br /> r/ fr g O -OTHER <br /> MELISSA R2RNI DTT.T.ARt) - - <br /> GeneratorAuthorizedAgentName i Shipment Date <br /> w Y $ _ _ ± rdnsporter[complete eg - -- <br /> I<, Gene(atorcdmptalet�; rans iter❑co m rete h�) <br /> -�TRANSPORTERI TRANSPORTERII <br /> Name:, � �/ J r f"�`Lk6 I/I G h. Name: <br /> Address: ..�^�y/ /w 1. Address: <br /> Driver Name/1 itle: rkAlF G A Y-rel) j:. Driver Name/frtle:. - <br /> // P NgrYPE Tc PmtfrfnPE <br /> Phone No. s`yl^���' yila!( e. Truck No.: ✓ a� k. Phone No.: - I. Trude No.: <br /> Vehicle License No./State: J hu 5 m.Vehicle License NoJState: <br /> Acknowledgement of Receipt of Materials. Acknowledgement of Receipt of Materials. <br /> 16)161 j I?tg If In. <br /> D' tura, <br /> Shipment Date Dn Si naNre Shi meet Dam <br /> 90tion III . DESTINATION (Genwator completes ad,destination site completes e-f) <br /> Site Name: <br /> BFI — MASCO ROAD SANITARY LANDFILL c. Phone No.: (925) 447-0491 <br /> �.. <br /> Physical Address: 4001 N. VASCO ROAD d. Mailing Address 4001 N. VASCO ROAf)i. <br /> LIVEP.MORE, CA 94550 LIVEIMRE, CA 94550 <br /> Discrepancy Indication Space: <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 /> —� JOB# 1007-114 <br /> L_7LILJ PO# 09-30308_---_---- <br />