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-waste No 854337 <br /> Systems TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • <br /> E%%0V t 5 A F%tion Station =7 -3330 <br />�neralor Name Generating Location <br /> Address P 0 Boa 4413 Address 3128 h Ben iamin Holt Dr <br /> 1 Houston Te%as 77310-4415 Stockton Calsfotnia <br /> Phone No = <br /> — 2 -t 6 8 r 0 0 Phone No <br /> tl Waste Code 1 0 6 1 1 1 7 1 9 1 2 1 9 6 1 ; Containers Type <br /> Description of Waste Quantity Units No T pe D Drum <br /> m C - Carton <br />' 0 0 0 1 8 I 0 I J I T B Bag <br /> NO?N HAZARDOLS T -Truck <br /> SOIL ❑ ❑ P - Pounds <br />' YYards <br /> 1 -1 F1m F-10 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 /> i <br /> I r� <br /> HCl L�l <br /> nerator Authorized Agent NarAe Signature —�f Shipmenf Daly <br /> 510-634-6850 <br /> Truck No Phone No <br /> Dillard Trurkinv Inc <br />�ansporter Name _ jGh i9,55 Driver Name (Pnnt���PC D i A/.<le/ZJ <br /> Address P 0 Box 218 Vehicle License No/State <br />' Bvron California 94514 <br /> Vehicle Certification l:5"G <br /> ereby certify that the above named material was picked up I hereby certify that the above named material was dekvered with <br /> the generator site listed above out incident to the destination listed below <br /> i e Signature Shipment Date Driver S-ignawrle Delivery Date <br /> Ite Name B F I Vasco Road Landfill Phone No 3 1 01-1 r 9 1 <br /> 4001 North Nasco Rd Livermore Ca 94550 <br /> dress <br /> ereby certify that the above named material has been accepted and to the best "y,.�nowledge the foregoing is true and accurate <br /> f Authorized A ens S: nature Recei t Dat <br />' PASS CODE <br /> 10!86 BF1260 720 <br />