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NON=HAZARDs06t AL VVAS.ii �STO.S.MA41FESt' <br /> ' <br /> If wasteIs asbestos waste,cgmptete Sections i,Q,III and iV, cal O G 1 A,%) �] <br /> . . N waste is NOT asbestos waste,complete only Sections L n and IQ. 1 Y J 1.G.�e G <br /> NERATORmf ram"ate W Sebboh7), ,�.. .__,. <br /> Generator Name: ARCO PRODUCTS COMPANY b. Generating Location: ARCO STATION 004932 <br /> Address` POB 5077 d. Address: .-16. E• HARDING <br /> BuEtA PARK, CA 90622-5077 STDCRTON, CA <br /> Phone No.: (925) 299-8891 PAUL SUPPLE I. Phone No.: N/A <br /> wenerof the generating facility differs from the generator,provide: <br /> Ownees Name: A= PRODUCTS COMPANY h- Owners Phone No.: Same .as I(e) <br /> TYPE <br /> BF]WASTE CODE C A 4 0 5 1 0 6 1 7 9 9 0 2 1 019 Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> B -BAG <br /> Description of Waste: NON—HAZARDOUS SOIL k. Quantity Unna No: TYPE BA -6 MIL PLASTIC BAG <br /> 0 or <br /> 0 0 O 1M <br /> T <br /> T -TRUCK <br /> O -OTHER WRAP <br /> 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 <br /> any applicable state law, has been property 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 hamrdous waste subject to the land Disposal Y .YARDS <br /> Restrictions,I certify and warrant that the waste has beefnr;fft accordan a requirements of 40 CFR Part 266 and is rw longer a M' -CUBIC METERS <br /> hazardous waste as defined by 40 CFR Part 261. Y Of ARCO P ' Ys -CUBIC YARDS <br /> O -OTHER <br /> MELISSA AIRN/ DILLARD <br /> Generator Authorized Agent Name /SYg re Shipment Date, <br /> .. ' Transporter 11 complete <br /> q-9 <br /> n <br /> :etlpn;Ti - TRANSPORTER (Generator complete ad; Transporter'I[oom late h�n <br /> Ttt PORTERI ; ��- TRANSPORTERII <br /> Name. )" - . Name: <br /> Address: I I. Address: <br /> ti <br /> Driver Name/Titte: t) j. Driver Name/Tltie: <br /> [ <br /> Phone \:-W- `. e. Truck No.: k. Phone No.: <br /> kI. Truck No.'. <br /> Vehfc�Vcense No./State ' - m.Vehicle License NoJState: <br /> Adcnowl me f Re eipt Materials. Acknowledgement of Receipt of Materials. <br /> n. <br /> naNre Shi merit Date 0d r Si nature Shipment Date <br /> DESTINATION (Generator completes a-d destination sRe completes a-t) <br /> BFI VS,SCO ROAD SANITARY LANDFILL c Phone No.: (925) 441-0491 <br /> Site Name:. <br /> Physical Address:. 4061 N. VASCO ROAD - . d. Mailing Address 4001 N. VASCO ROAD <br /> LIViRMORE, CA 94550 LIVERMORE, 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 /> ' PO# 09-30308 <br />