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r Waste No <br /> SyStS �M <br /> ROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> INDUSTRIES <br /> PF <br /> r4 �, ., <br /> ienerator Name Generating Location <br /> Adress P 0 Boy. 441; Address " 'A G eit i inti Holt Di <br /> Houston Te\a!: -731n x=y_ <br />'hone No 2 4 �' r J Phone No <br /> IFI Waste Code A 4 0 i k Containers Type <br /> Description of Waste Quantity Units Noe 0- Drum <br /> 0 0 I C -Carton <br /> El [ B - Bag <br /> NO% HAZARDOUS T -Truck <br /> SOIL ❑ m ❑ P - Pounds <br /> Y-Yards <br /> ❑ L.� ❑ 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 to proper condition for transportation according to applicable regulations <br /> 3enerator Auttrorized Agent Name 3ignaw 7 - Shipment Date <br /> TRANSPORTER <br /> l <br /> 51 0-0J4-6850 <br /> truck No Phone No <br /> Dillard Trucking* Inc 2 5 <br /> Transporter Name Driver Name (Pant) <br /> 4ddress P 0 Box 218 Vehicle License No/State <br /> Bvron Californ2a 94514 304b 2 <br /> Vehicle Certification <br /> l 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 /> a '` f.l l� to l � - <br />:)nver Signature Shipment Date Dnver Signature Delivery Date <br /> DESTINATION <br /> Site Name B F I Z rico Riad La 3af 311 Phone No — 4 4 1+ <br /> 4001 'nor to `asc; Ra ;,%ernrore Ca 94553 <br /> Address <br /> I hereby certify that the above named material has been accepted and to it e est of my knowle T the foregoing s true and accurate <br /> Authorized Agent Signature / "--IPI Date <br /> PASS CODE <br /> 10186 !� BF126C <br />