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m <br /> Waste No 854332 <br /> Systems 7M <br /> BROVVNINGFERRISINDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATy� , <br /> j �l YS- <br /> Generator Mame Exxon Company U S A Exxon Station *7-3330 <br /> Y G_r era`ing Location <br /> Address P 0 Box 4415 ]d� s `. 3128 W Benjamin Holt Dr <br /> Houston Texas 77310-4415 Stockton California <br /> 5 1 0 — 8 7 0 0 <br /> Phone No's Phone No �— <br /> BFI Waste Code C A 4 0 5 1 0 1 6 1 1 F7 9 2 1 9 6 1 7 Containers Type <br /> Description of Waste Quantity Units No T e O- Drum <br /> 0 0 0 1 8 El 0 S C-Carton <br /> ICON HAZARDOUS <br /> B - Bag <br /> SOIL -- ❑ m ❑ T -Truck` i <br /> P -Pounds t <br /> Y -Yards <br /> Elm LlO•ether <br /> L <br /> I tie4e Zcerbfy that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 or any applicable <br /> statelaIs <br /> w; rnot p 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 condi nsport tion according to applicable regulations <br /> ?.: , r <br /> Generator Authorized Agent Name- -+•,w..,.' , Slgnafure Sh+pmen Date <br /> • <br /> 510-634-6850 <br /> Truck No r^� - ' Phone No <br /> h" Dillard Trucking Inc <br /> Transporter Name _ Jo_ tL55 Driver Name (Print) <br /> Address P 0 Box 218 <br /> Vehicle License No /State U � � %7.s , <br /> Byron, California 9951-I <br /> Vehicle Certification � 3 3 <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with <br /> at the enerator site listed above out sncide t to the destination listed beloyv <br /> t <br /> 2 <br /> Dnve S+gnat e y Shipment Date Drive Signa ure Delivery Date <br /> FA If[01 <br /> Site Name 't B F I Vasco Road Landfill <br /> ... Phone Na <br /> Address <br /> 4001 North Vasc6 Rd , Livermore, Ca 94550 <br /> I hereby certify that the above named material has been accepted n t a(f;2of my knowledge the foregoing is tr ccurate <br /> NadUkof Authorized A gni S+ nature Receipt Date <br /> PASS CODZ= <br /> 1018& <br /> BF1260 720 <br />