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Waste No. 951229 <br /> Systems TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Santa Fe Railwav Company Jersev Island <br /> Generator Name Generating Location <br /> Address 740 East Carnegie Road Address Jersey Island, CA <br /> r�San Bernardino, CA 92408 <br /> Phone No. Phone No. <br /> BFI Waste Code ED "t P T I I I I I I I I I Containers Type <br /> Description of Waste Quantity units No. T D-Drum <br /> U 0 0 2 U Y❑ 0 / <br /> T <br /> B-Bagrton <br /> LLJJ 9 <br /> COtiS'IRUCTION DED1G LUMB F.R 1 El T -Truck <br /> / ! <br /> P•Pounds <br /> , ,�;.:.; Y-Yards <br /> El m ElO-Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, <br /> classified and packaged, and is in proper condition for transportation according to applicable regulations. <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER, <br /> �7 <br /> Truck No. --� Phone No. 510-634-6850 <br /> Transporter Name Dillard Trucking, Inc. 27911 Driver Name (Print) <br /> Address F. O. Box 218 Vehicle License No./State t.J <br /> Byron, California 94544 <br /> Vehicle Certification 3 9 7�� <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the gbner�torsite.listed above. --6ut igcident)to the destination listed below. <br /> l i , <br /> 4 \ J ? e <br /> Driver Signature _._} Shipment Date Driver Si5ilaturs Delivery Date <br /> DESTINATION <br /> Site Name —1 B.F. I . ;..sco Road L_-::ci iil - Phone No. ' 1 '-' 4 k 17 0 v 9 r <br /> N11-t.i1 Vasco Hai. , L;veci.ore, Ca. 4-5'i, <br /> Address <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 /> Name of Authorized Agent Signature Receipt Date <br /> PASS CODE <br /> 10186 BF1260-720 <br />