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r Waste No 854330 <br /> 1 <br /> Systems 7M NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> 30 G-IrERRIS INDUSTRIES <br /> • <br /> E\,011Conlpanv C S a �.�Yon Statluii �- ' 330 <br /> enerator Name Generating Location <br /> ddress <br /> P 0 Box 4415 Address 3128 U Benjamin Holt Dr <br /> Houston Texas 77310-4415 Stockton California <br />'hone No 2 4 6 8 7 0 O 1 Phone No =— <br /> F]:I]:]= � <br /> Containers Type <br /> IFI Waste Code C A 4 4 5 0 6 1 7 9 2 1 9 6 1 7 D - Drum <br /> Description of to Quantity Units No Type C - Carton <br /> 0 0 0 1 8 El I-_ 1 C J B Bag <br /> T -Truck <br /> NON HAZARDOUS ❑ m ❑ P - Pounds <br /> SOIL <br /> Y Yards <br /> ❑ m ❑ O Other <br /> 1 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 /> ��' [I f L <br /> �� r Z ' L <br /> y signature <br /> ' Shipment Date <br /> Ge r Authorized Agent N me g <br /> TRANSPORTIER. .. <br /> 510--634-6850 <br /> Truck No Phone No <br /> Dillard Trucking Inc (Print) --r7/ <br /> Transporter Name - Driver Name (Print) <br /> Address <br /> P 0 Bok 218 Vehicle License No/State 6 7! <br /> Byron California 94514Vehicle Certification 300__`r! 7 <br /> 1 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 /> EL:E= <br /> , �, z <br /> / � lt� Delivery Date <br /> Driver Signature Shipment Date Driver Signature <br /> DESTINATION <br /> Site Name <br /> $ F I Vasco Road Landfill Phone No 5 1 0 — 4 4 7 0 4 9 <br /> 4001 North Vasco Rd Livermore Ca 94550 �- <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of m' owtedge the f g is true and accurate <br /> Si nature - / Receipt Date <br /> a oS Authorized A ent t <br /> PASS CODE <br /> B F 1260 <br /> 10186 <br />