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j Waste No ! -3 c 2 1 ! <br /> BROWNING-FERRIS INDUSTRIES TM INDUSTRIESNON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR­ . � <br /> Generator Name Generating Location <br /> Address C ` f'N 'i'1'' Address 3_28 k r ui, t ii Rc,1 t Lt <br /> 77110 111 . <br /> Phone No _ s Phone No LTJ <br /> BPl Waste Code r } '- ' _ `' 6 Containers Type <br /> Description of Waste Quantity Units No T pe D - Drum <br /> 0 n i t a C - Carta <br /> B - Bag <br /> \0\ h�.Z.s.RL16,S T -Truck <br /> SOIL ❑ m ❑ P - Pounr <br /> Y -Yards- <br /> F-1 <br /> ards❑ m E] 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 CPR 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 /> { 12- 1 <br /> Generator Authorized Agent Name gignatu Shipment Date <br /> TRANSPORTER <br /> Truck No Phone No <br /> FiiII—ard Tru, Ping inc 2 55 <br /> Transporter Name Driver Name (Punt) <br /> Address r 05 'o` 2:Z Vehicle License No 1StatL> LL� �� <br /> Br.rar, Caiwfarnja 94514 <br /> Vehicle Certification 22 4 3r6 <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered witl <br /> afftl Heratite listed above out incident to the destination listed below <br /> / Q1 .2 <br />/Dnver Signature Shipment Date Dnver Signature Delivery Date <br /> DESTINATION <br /> Site Name F F 1 �,a-r o Ruad Laadf 3] a Phone No `' O — 0 1 4 1 9 <br /> r01 \c _`, t os, t, Ru ` i eruioI F Ca 94550 <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best o i�y �wledge the foregoing is true and accurate <br /> E: <br /> 1 1 Authorized Agent Signature <br /> i ; Recei ate <br /> PASS CODE <br /> 10186 BFI261 <br />