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NON-HAZARD SPECIAL WASTE'AL JAESTOS MANIFEST <br /> - If waste is asbestos waste,complete Sections I,IL III and W. <br /> If waste is NQJ asbestos waste,complete only Sections I,17 and III. NO-512493 <br /> r <br /> o � E,ER1 ORS aaI f mit <br /> r. Generator Name: ARCO PRODUCTS CCMPAKY b. Generating Location: ARCO STATION $04932 <br /> :. Address POB. 5077 d.Address: 16 E. RARDING <br /> BUENA PARR, G 90622-5077 8TOCKTfA, CA <br /> r <br /> Phone No.: (925) 295-8891 PAUL SUPPLE f. Phone No.: K/A <br /> owner of the generating facility differs from the generator,provide: <br /> 1. Owner's Name: ARCO PRODUCTS COMPANY - h. Owner's Phone No.: Same as 1(e) <br /> �E <br /> BFI WASTE CODE C A 4 MOS O 6 1 7 9 0 2 1 0 9 Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> NON—HAZARDOUS SOIL B -BAG <br /> Description of Waste: k. Quan' Units No. <br /> N�o. TYPE BA •6 MIL PLASTIC BAG <br /> or WRAP <br /> 0 0 0 Y 0 1 T T -TRUCK <br /> O -OTHER <br /> GENERATORS 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, Gasified and packaged,and is in proper condition for transportation according to P -POUNDS <br /> applicable regulations;AND,it the waste is a treatment residue of a previously restricted hatardous waste subject to the Land Disposal Y •YARDS <br /> Restrictions,1 certify and warrant that the waste has been treated In <br /> ,pocerdance with the requirements of 40 CFR Part 266 and Is no longer a M' -CUBIC METERS <br /> hazardous waste as defined by 40 CFR Part 261. at ,(re St f ARCO m Y' -CUBIC YARDS <br /> ;`�•�? O -OTHER <br /> MELISSA ICI£.`1f DTL•I ARIf _ `17,!� <br /> Generator Authorized Agent Name Signarii a Shipment Date <br /> iectionII TRANSPORTER Generator complete Tmnsportertcrompietee-g <br /> p .�31' Trens rterII00m etehn j <br /> ��r{ /��(7]( TRANSPORTER I TRANSPORTER II <br /> /K <br /> . Name: r wiji mzA/Jsiaae't' h. Name: <br /> • Address: 9'a -IR&J'a a5- I. Address: <br /> 4-ad � 'Ca•950 1 -� ads <br /> Driver Namefriide: �^_ Z - J. Driver Name/Title: <br /> � 7V i PRIM. Tr T� PRIM/rYPE <br /> . Phone No. } 7 i�" e. Trude No.: 1 � k. Phone No.: I. Truck No.: <br /> Vehicle License NOJState7ZVa%-77;57WHO m.Vehicle License NoJState: <br /> Acknowledgement,of Receipt of Materials. Acknowledgement of Receipt of Materials. <br /> SN meal DeM Driver S' .W. Shi t Dare <br /> ',ales".destination site completes e f) =Nom, <br /> Site Name: BFI — VASCO ROAD SANITARY LANDFILL c. Phone No.: (925) 447-0491 <br /> Physical Address: 4U01 N. MASCO ?LOAD d. Mailing Address 4001 N. VASCO ROAD <br /> LIVERMORE, CA 94550 LIVF.R,`4011r, CA 94:,50 <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 /> /1- JOB# 1007-114 <br /> POfi 09-30308 <br />