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1 Waste No f �. <br /> 1 <br /> Systems TM <br /> 8A WNING-FtRRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name Generating Location <br /> Address P 0 Do\ 's - Address <br /> 1-011 Tez• _7110 -4-111- <br /> Phone <br /> 110 -4-11.Phone No 4 — , u L J Phone No <br /> BFI Waste Code 4 0 5 a 1 1 Containers Type <br /> Description of Waste QuantityUnits No T pe D- arum <br /> C - Carto <br /> E <br /> 1-1 l T <br /> t B - Bag <br /> 114ZARDOR 5 T -Truck <br /> >OII <br /> ❑ P - Poune <br /> Y-Yard, <br /> ❑ m ❑ O- Othei <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 1100 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 transportation according to applicable regulations <br /> Generator Authorized Agent Name Sijnalunr V Shipment Date <br />' <br /> TRANSPORTER <br /> i 34-6f'S0 <br /> Truck No Phone No <br /> f , <br /> Dillard Trucking Inc 2, 55 1 <br /> Transporter Name Driver Name (Print) <br /> Address 1- 0 Boa 218 Vehicle License No /State <br /> B,,ion Califorr d 94514 <br /> Vehicle Certification <br /> 1 hereby certify that the above named material was picked up I hereby certify that the above named material was delivered wit <br /> at the generator s to listed above out incident to the destinatlonlisted below <br /> ZI <br /> r <br /> Driver Signature / Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> Site Name B F r Casco Rona Landfill Phone No �— 4 4 1; 1 0 4 <br /> 001 'North Nasro Rd Li%ermore Ca 94 x.-� <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of my_kn wledge the fore oing is true and accurate <br /> of Authorized-Agent Si nature Receipt Date <br /> PASS CODE <br /> 10!86 BF126 <br /> - r <br /> �A � <br />