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o i <br /> Waste <br /> No - �^ <br /> r t <br /> OSystems <br /> TM <br /> !9 WNING-FEAfiiS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name Generating Location <br /> Address r t' 80 4 3 ' Address 31 28 t4 Ren i s'is 1y f o]t. D, <br /> 110' "i T L 3 fc <br /> Phone No LL I 0 H 14 16 s r 0 G j Phone No <br /> BFI Waste Code C a4 1.0 1 k 1 r Containers Type <br /> Description of Waste -Quant Units No Type D- Drum <br /> LC-Cartc <br /> 0 0 0 ] O El <br /> B - Bag <br /> NON HAZARDOUS T -Trucl <br /> SOIL ❑ m ❑ P - Poun <br /> Y -Yard <br /> F] m F1 -Othe <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 in proper condition for transportation according to applicable regulations / <br /> Q 2 <br /> Qwwqator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> Truck No Phone No 510-634-6850 <br /> D_.1 'Lai d "_rucking T lc 2 _55 f� -, J" <br /> Transporter Name Driver Name (Print) <br /> - f <br /> Address F 0 Box 218 Vehicle License No/State �- <br /> Bvron CdI fornid 84:,14 <br /> Vehicle Certification <br /> I hereby certify that the above named material was picked up l hereby certify that the above named material was delivered wi <br /> at the generator site listed above out incident to the destination listed below <br /> Driver Signature Shipment Dale Driver Signature Delivery Date <br /> DESTINATION <br /> Site Name B t I 4ascu Road Landfill Phone No —14 , 7 IQ 14 c <br /> 400; tion: .zsco Rd, Ll veltrore Ca 94550 <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing i!�C and-accural <br /> 1A11111- <br /> RMe of Authonz lent Stgnature Rece t Date <br /> 7 <br /> 7- CODE <br /> 14186 BFI2 <br />