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rNON.HAZAR�A SPECIAL WASTE &,�-_AESTOS MANIFEST Ifwaste is asbestos waste,complete Sections 1,IL III and IV. No. 512495 H waste is UQJ asbestos waste,complete only Sections I,II and III. a. Generator Name: AROD PRODUCTS COMPANY b. Generating Location: ARCO STATION #04932 :. Address PUB '5077 d. Address: 16 S. HARDING BUENA PARK, CA 90622-5077 STOMW, CA a. Phone No.: (925) 299—"1 PAUL SUPPLE I. Phone No.: N/A f owner of the generating facility differs from the generator,provide: 3. Owner's Name: ARCO PRODUCTS COMPANY h. Owner's Phone No.: SWW as I(e) TYPE BFI WASTE CODE C 4 5 6 7 9 9 2 09 Containers DM-METAL DRUM DP -PLASTIC DRUM B -BAG Description of Waste: NON-HAZARDOUS SOIL k. Quanti Units No. TYPE BA -6 MIL PLASTIC BAG 0 0 01M or 0 -OTHER WRAP GENERATOR'S CERTIFICATION: f 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 regulations;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 beep �� ed/ip,accordance with th requirements of 40 CFR Part 268 and is no longer a M' -CUBIC METERS hazardous waste as defined by 40 CFR Part 261. 11e a /t f ARCO Y , -OTHER YARDS O MELISRA KIRK/ T:Ti.T.ARn 2- Generator Authorized Agent Name Aignaiture Shipment Date "a �� >=f(a:. + ys tiFl ; .<,.,,„.,,5,,�y .. , ... TrensporterIcom latrog .,ys _ 'r S _ I � , r a >� air ., i a bA�'$R'-{Generator comPlate a-d;irans erucorr�tete h-n -.rsr'.g=. A, //�/1 TRANSP /ERI /-� TRANSPORTER II 1. Name: 1:�` moi! �t (i L��c /It h. Name: >. Address: . 1 i. Address: S / :. Driver Name/Idle: t Driver Name/Tide: �7�INT. Tr PRIM. Tr YPE I. Phone No.:� 1 d� � ��L. e. Truck No.: � k. Phone No.: I. Truck No.: Vehicle License No./State: ��.JQ X I ? 7 m.Vehicle License No./State: Acknowled emen{tt of Receipt of Mate als. Acknowledgement of Receipt of Materials. Tl D66r Signature Shl merit Date Driver signature Shi ment Date irn�.r 'fs'... s �'` r - - x. .... _ r �s�1011 ;c,; = a.;i:"� ' .,;i=D"E$�'1NAT(ON fGermratoroornPletes'atl des(inadonstecompla"64.) -'r ':- -I'r' .. Site Name: Bi'I - VASCO ROAD SANITARY LANDFILL c. Phone No.: (925) 447-0491 Physical Address: 4,;01 Pd. VASCO ROAD d. Mailing Address 4001 N. VASCO ROAD T_.IVERIAORB, CA 94550 LIVERMORE, CA 94550 . Discrepancy Indication Space: I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. JOB,# 1007-11,- 7 PO# G9-30308 _. ...._. ce.....a rmm