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6 <br /> Waste No �, '} � R <br /> Systems Tµ <br /> iROWNINta-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> generator Name Generating Location <br /> address 0 Box 4415 Address 2, ik Rei iar in holt u� <br /> gojsro„� Ti\as 7731,(1- 34,1s <br />'hone No v 1 0 ` 1 L 1 I I Phone No �— <br />;Fl Waste Code ` C ' Containers Type <br /> Description of Waste Quandt Units No 7 e D - Drum <br /> ❑ 0 / C - Carton <br /> B - bag <br /> NON HAZ ARDOL S T -Truck <br /> SOIL ❑ � ❑ <br /> P - Pounds <br /> Y - Yards <br /> F-1m El -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 1s In proper condition for transportation according to applicable regulations <br />.enerator Authorized Agent Name SignatA Shipment Date <br /> TRANSPORTER <br /> 10-614-6850 <br /> ruck <br />"ruck No Phone No <br /> Dillard "TrurvinL- Inc 2 53 <br />"ransporter Name Driver Name (Print) <br /> lddress P 0 Bo\ 218 Vehicle License No/State <br /> Bron California 94514 <br /> Vehicle Certification <br /> hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with <br /> it the genetalar site listed above out Incident to the destination listed below <br /> , <br />)river Sature Shipment Date Driver Signature Delivery Data <br /> DESTINATION <br /> Site Name B F I t asro Roaa Lanaf i l l Phone No —14 4 ' 0 4 g <br /> =001 \ortli 1asco Fd L]xer ncze .a 94550 <br /> address l <br /> hereby certify that the above named material has been accepted and to the beZmykdg thefor ing Is try and accurate <br /> a uthonzed Agent Signature acek t Date <br /> CZ PASS CODE <br /> 10186 BF1260 <br />