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l Waste No <br /> Systems 7M <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name Generating Location <br /> Address Address 128 <br /> Phone No Phone No <br /> BFI Waste Code 1 � Containers Type <br /> Description of Waste Quantity Units No Type D- Drum <br /> � E:1 � C -Carto <br /> B - Bag <br /> SOI:fi,�Z�RPC)u S T -Truck <br /> SOIL ❑ ❑ P - Pounc <br /> Y - Yard: <br /> F-11 F1 Othei <br /> 1 hereby certify that the above named material does not contain free liquid as defined by 40 CFR Parti 2601 10 for 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 /> ko <br /> Gen rator Authorized Agent Name T <br /> 9 Signatur Shipment Date <br /> TRANSPORTER <br /> 510-639-6850 <br /> Truck No f Phone No <br /> Transporter Name <br /> rDi1lai e Tr t(-kli,e ? Z <br /> � Driver Name (Pant) <br /> Address {3 uO� 2' Vehicle License No/State <br /> Bvron Califo­ ,r �,45_4 C Irl � ! <br /> Vehicle Certification t <br /> I hereby certify that the above named material was picked up I hereb�certify that the above named material was delivered witl <br /> at the generator site listed above %opit incid` t to the destination listed below <br /> l _ j <br /> Driver Signature y Shipment Date Driver Signature W Delivery Date <br /> DESTINATION <br /> Site Name I 7 c 5 3 -3 9 C q <br /> Phone No <br /> 100_ \ut U 1�d r lxel m)re Ca L"4 5�0 <br /> Address - <br /> I hereby certify that the above named material has been accepted and to the best of my_krrbwled a foregoing is true and accurate <br /> �r <br /> a Authorized A ent Si nature /' _14i Recei !Date <br /> PASS CODE <br /> s>=1260 <br />