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:NON-HAZARAS_SPECIAL WASTE A(%ESTOS MANIFEST <br /> B waste is`asbestos waste,complete Sections 1,q III and IV. N Q. 512496 <br /> If waste Is NOT asbestos waste,complete only Sections L II and III. <br /> a. Generator Name: ARCO PRODUCTS C0110ANY b. Generating Location: ARCO STATION #04932 <br /> c. Address 'POB. 5077 d. Address: 16 E. HARDING <br /> BUENA PARKe CA 90622-5077 STOCKTON, CA <br /> e. Phone No.: (925) 299-8891 PAUL SUPPLE I. Phone No.: N/A <br /> If owner of the generating facility differs from the generator,provide: <br /> g. Owners Name: ARCO PRODUCTS COMPANY h. Owners Phone No.: Same as I(e) <br /> M F TYPE <br /> I. BFI WASTE CODE C A 4 O 5 0 6 1 7 9 9 0 2 3- U 5 Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> B -BAG <br /> j. Description of Waste: NON-HAZARDOUS SOIL k. Quantity un�ns No. TYPE BA -6 MIL.PLASTIC BAG <br /> or WRAP <br /> 0 0 0 Y 0 1 T -TRUCK <br /> O -OTHER <br /> GENERATOR'S CERTIFICATION: I hereby certify that the above named material is not a hazardous waste as defined by 40 CFA 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 hazardous waste subject to the Land Disposal Y -YARDS <br /> Restrictions,I certify and warrant that the waste has been, ted i accordance wi F. a requirements of 40 CFA Part 268 and is no longer a M' -CUBIC METERS <br /> hazardous waste as defined by 40 CFR Part 261. /. a of ARCO V' -CUBIC YARDS <br /> been <br /> O -OTHER <br /> Generator Authonzed gent Name ig u ' Shipment Date <br /> v ,ova#'>, Trensporter I complete 8-gtr <br /> 9eCtR)F] ,. �, . � BANSPORTER = Gegerato complelaexl;<Trens Hcom letet�n.) <br /> J TRANSPORTERI TRANSPORTERII <br /> a. Name: h. Name: <br /> b. Address: 7329/ Okf S �� 44�T I. Address: <br /> c. Driver Name/Title: L�1J � 7Q /��'S..o. j. Driver Name/Title: <br /> PINT'rYPE PRINTfryPE <br /> d. Phone No.:f� 6,75- �.t'' e 1 c�No.:29�3�d k. Phone No.: I. Truck No.: <br /> f. Vehicle License No./State: .. G7 VL' 7 ? m.Vehicle License No./State: <br /> Acknowledgement ceipt of Materials. p c� Acknowledgement of Receipt of Materials. <br /> n. <br /> Diner ' nature Shi nt Date Driver S' nawre Shiprnent Date <br /> DES`f'INi4TIONt(Gerhetator'co*0asatdf;destnationI-it ecomPletesei) <br /> a. Site Name: BFI - VASCO ROAD SANITARY LANDFILL c. PhoneNo.: (925) 447-0491 <br /> b. Physical Address: 40-.1 N. VASCO ROAD d. Mailing Address 4001 N. VASCO ROAD <br /> LIVERMORE, CA 94550 LIVERI4ORE, CA 94550 <br /> e. 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 /> J 1)29 1007-11A <br /> f. �J " POW 09-3. 308 <br />