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OWaste No <br /> Systems 'rmr <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> ♦�� � ori._ _ -- - 1 <br /> Generator Name Generating Location <br /> Address 11 `i `'O\ 4.4I5 Address 3'`8 1' I Ilett to <br /> 1' lig :"1d� 1 i - �-�1.) �L")c <br /> Phone No v 0 1 Jr. $ 17 11 u Phone No <br /> BFI Waste Code a 0 ' ' 1 ' Containers Type <br /> Description of Waste Quantity Units No Type D- Drum <br /> ❑ L._l B - Carton <br /> � - bag <br /> ^;O: HAZARDOUS Elm ElT -Truck <br /> SOIL P - Pound: <br /> Y -Yards <br /> I t L F] El - Other <br /> E 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 tra�nsportation according to applicable regulations <br /> } r� <br /> Generator Auttionzed Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> t <br /> 5�o-634 -e850 <br /> Truck No f7 _ Phone No <br /> Dillard Trvrlcint Inc2 55 <br /> Transporter Name Driver Name (Print) – <br /> Address F 0 Bax 218 Vehicle License No/State <br /> Bv;ori California 94514 ` fes <br /> Vehicle Certification <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 /> F <br /> Dnve��S�nakrre Shipment Date mature Delivery Date <br /> DESTINATION <br /> Site Name 8 F I Vasco goad Landfill Phone No 1 —1 -1 4 ` FT 9 <br /> 4001 \u. tfi �atiro Rd Lik ermor e Ca 9-,530 <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of--friy.,knowledge the foregoing is true and accurate <br /> .- , rte, G <br /> Authonzed A ent <br /> Signature 'Receipt Dat <br /> PASS CODE <br /> 10186 <br /> BEi266 <br />