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0e <br /> Waste - - No' 951212 <br /> `Systems '" NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> BROWNING-FERRIS INDUSTRIES <br /> GENERATOR <br /> Santa Fe Railway Compday Jersav Island <br /> Generator Name Generating Location <br /> Address 740 East Carnegie Road Address Jersey Island, CA <br /> San Bernardino, CA 92408 <br /> Phone No. Phone No. <br /> BFI Waste Code M P T Containers Type <br /> Description of Waste Quanti Units No. T e D-Drum <br /> C.Carton <br /> B-Bag <br /> CONSTRUCTION ,DEMO LUMBER T -Truck <br /> P-Pounds <br /> Y-Yards <br /> ' ❑ m ❑ o-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 Data <br /> TRANSPORTER <br /> 3 510-634-6850 <br /> Truck No. Phone No. <br /> Transporter Name Dillard Trucking, Inc. 279/1 Driver Name (Print) y <br /> Address P. 0. Box 218 Vehicle License No./State 4 c D �S2 gy <br /> Byron, California 9454+ '3 0o g/ 0 <br /> Vehicle Certification �l <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 generator site listed above. out incident to the destination listed below. <br /> 1 <br /> Driver Signature Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> 1 111 J <br /> Site Name B.F. I. Vascn Road Land.E i.1 Phone No. y 4 ) 4 <br /> a0�1; North Y'as«i Rd. , Lit'.:-r.:.,..,, '::a. <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of my knpOedge the foregoing is true and accurate. <br /> r - <br /> Name of Authorized Agent Signature /` cein,Dale <br /> PASS CODE <br /> 10/96 BF1260-720 <br />