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Waste No 854321 <br /> Systems YM FAD SPECIAL WASTE MANIFEST <br />�WNWG-FERRlS INDUSTRIES �NON-HAZARDOUS OUS SP <br /> ierator Name CorUr�n� t S Generating Location �ti�crn ctat,on - X330 <br /> Tress P 0 Box 4415 Address 3128 1% Ben3amin Holt Dr <br /> Houston Texas 77310-4416 Storlton California <br /> ne No [ '=_j 0 — 2 1 4 6 T3 I.-, G G Phone No <br /> 0 6 1 7 9 2 1 9 6 1 7 Containers Type <br /> Waste Code D Drum <br /> Description of Waste Quantity Units No Type D - Carton <br /> 0 fl 0 8 1 E 0 F B gag <br /> NON HAZARDOUS T -Truck <br /> SOIL ❑ m ❑ P Pounds <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, 1s 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 /> 0 1 f L L i, -C yC�1 <br /> 3rator Authorized Agent N me Sign tur Shipment Date <br /> • <br /> 510-634-680 <br /> ck No q Phone No <br /> Dillard Trucking Inc J I <br /> nsporter Name � ��,�� Driver Name (Print) <br /> cress P 0 Boy. 218 Vehicle License No /State <br /> Byron California 94514 <br /> Vehicle Certification <br />�reby certify that the above named material was picked up t hereby certify that the above named material was delivered with- <br /> he generator site <br /> listed above out Incident to the destination listed below <br /> 2�r Sigr#ure Shcpment Date Driver Signature Delivery Date <br /> DESTINATION <br /> Name R F I Vasco Road Landfill Phone No <br /> 4001 North Vasco Rd Li%ermore Ca 94550 <br /> gess <br />-reby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> honied A Signature �� Receipt Date <br /> r <br /> PASS CODE <br /> 16 <br /> BF1260 721) <br />