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e a <br /> r Waste No <br /> Systems TM <br /> 3ROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • <br /> generator Name Generating Location <br /> 4ddress n 0 Bn-\ Address ?8 t. ut tl 1'�ril I n <br />'hone No V } J Phone No <br /> 3FI Waste Code r 0 Containers Type <br /> Description of Waste Quandt Units No T pe D - Drum <br /> t - - <br /> C -Cartor <br /> E T <br /> B - Bag <br /> NON dAZARDOL� T -Truck <br /> SOIL ❑ m ❑ P - Pound <br /> Y -Yards <br /> ❑ 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 /> CAF U dFM tlr-R7 C_> �1��- - 2 <br /> 3ener for Authorized Agent Name Signature Shipment Date <br /> 1l1 !!AA11 r Cs TRANSPORTER <br /> t �11�L J kt1—tr.fie—fJ�iJ�i <br /> truck No Phone No <br /> 1 Dillard Truckzn� °nc 2 _J 4 <br /> rransporter Name Driver Name (Punt) <br /> Address OF BOA 21`� Vehicle License No/State 4� <br /> Bron California �I <br /> Vehicle Certification -' I <br /> t hereby certify that the above named material was picked up hereby certify that the above named material was delivered witt <br /> at the generator site listied above ut i tt to the destination listed below <br /> Elm= <br /> Driver Signature Shipment Date Driver Signature Delivery Date <br /> EL=:E1K4 L"' <br /> DESTINATION <br /> Site Name E F I %asco Roue landf i 1 Phone No FM__ 4 4 J a <br /> 4001 \011,11 F'j L i\ern of e -a 94.550 <br /> Address <br /> I hereby certify that the above named material has been accepted and to the besy6f my knowledge oregoing is true and accurate <br /> '� 01 _ <br /> a Authorized A ent Si nature / ". Receipt Date <br /> PASS CODE <br /> 10186 BF126C <br />