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Waste NoO <br /> Systems TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name Generating Location <br /> Address P O Anti 4415 Address 8128 lw Bentimir Holt D <br /> llouSto�1 TeNms z 1()- , _i: Storl.ton ( a I I"0 L n a <br /> Phone No 0 1 0 i 6 Phone No <br /> C ,� 4 G 7, 1 t 7 , Containers Type <br /> BFl Waste Code <br /> Description of Waste Quantic D - Drum <br /> Units No Type 0 . Drum <br /> ? m ' <br /> Cartot <br /> B - Bag <br /> NON HAZARDOUS T -Truck <br /> sozL <br /> ❑ El P - Pound <br /> Y - Yards <br /> ❑ m ❑ O- Other <br /> 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 /> GREG bF At AR 7 0 �'�,� ,d_ n 5 9 <br /> Generator Authorized Agent Name Signatures 4V Shipment Date <br /> - ..TRANSPORTER <br /> 510-634-6850 <br /> Truck No Phone No <br /> Dillard Ti ttCking Inc 2 ' .5 ,4l �iC�� K <br /> Transporter Name Driver Name (Punt)� _ <br /> Address 1, ` B°� 218 Vehicle License No/State <br /> Bvron California 94514 �� <br /> Vehicle Certification � � ' <br /> hereby certify that the above named material was picked up I hereby certify that the above named material was delivered watt <br /> at the generator site listed above J out incident to the destination listed below <br /> F I r I <br /> Driver Sgnature Shipment Date Duvet Signature Delivery Date <br /> DESTINATION <br /> B F I Vasco lxoF� �_,n(Ji_1 .t 4 7 4 0 <br /> Site Name Phone No <br /> J <br /> -BUJ] 'tort ba r'. h , Lik erijo e u 4 5 J <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of my knowledg a fo oin ie 2n ae <br /> Authorized A enc Signature Recei t Date <br /> PASS CODE <br /> 10186 13F126o <br />