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1 <br /> Waste No 7 3 a ? <br /> Systems TM <br /> eRowNtN G-F_RRis INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR ' <br /> Generator Name Generating Location <br /> Address P Sox ]1 101t D- <br /> Address <br /> la <br /> Phone No Phone No <br /> Containers <br /> BFI Waste Code 4 -� Type <br /> Description of Waste Quantity Units No T pe D-Drum <br /> � 1 � �"`"� C-Carto <br /> %0'\ HAZ�RUOL� <br /> W B - Bag <br /> SO I Em T -Truck <br /> El El <br /> P - Paunc <br /> Y-Yards <br /> F] m ❑ 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 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 /> GR F(f by m PR7c ZQ G — / <br /> Generator Authorized Agent Name 5tgnatu Shipment Date <br /> TRANSPORTER <br /> X10-L") 6850 <br /> Truck No Phone No <br /> >;�ilatd Truckicic inc 2 5 <br /> Transporter Name Driver Name (Print) /7 <br /> P Q Bei 2111 � <br /> Address Vehicle License No/State 41 , <br /> Btrcn Celiforn?a 94714 _ <br /> Vehicle Certification :f2 (:�7 E2_z <br /> 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 site listed above out incident to the destination listed below <br />'�ifver Stg t - <br /> ura / Shipment Date Xh er c natur a waryate <br /> DESTINATION <br /> B F I Vasco Roaa z andf i l l � � 0 4 4 'r 0 4 <br /> Site Name Phone No <br /> 4001 \orth \asr c Re r i\ e. mo* E Ia 9-15Z0 <br /> Address <br /> hereby certify that the above named material has been accepted and to the_best-of--my kn ledge thefo�rtg-4s-trtfo and accurate <br /> F f Aufhortzed Agent Signature Reset t Date <br /> I _ � <br /> cPASS CODE <br /> 10186 13F1260 <br />