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Waste No 854311 Systems TM BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST • LtiNott 5I-,Ioil =7-3330 Vddress erator Name Generating Location P 0 Box 4415 Address 3128 h Bentamin Holt Di I _ "oust on Te\as 77310-41 15 Sto-kton C:i _ Fo_ 'a Phone No 1 0 —1214 1618 17 0 Phone No �I Waste Code 1 . 0 G 1 7 1 9 1 2 11 1 9 6 1 1 7 Containers Type Description of Waste Quantity Units No Type D - Drum 0 0 0 1 ; T- a C Carton �J B - Bag NON HAZARDOUS T - Truck SOIL ❑ �� -� ❑ P - Pounds Y - Yards ❑ m ❑ O- Other .' state law, 1s not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, classified and packaged, and is in proper condrt on for tr !ortation according to applicable regulations l 1 � Wnerator Authorized Agent Nanie Signature - Shipment Wte � 510-634-6830ruck No Phone No Dillard Trucking Inc (,Jct lansporter Name __ _,a, , , T Driver Name (Print) Address P 0 Box 218 Vehicle License No /State ' Byron California 94514 - i L ,_ r , Vehicle Certification I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with the generator site listed above out incident to the destination listed below Iver Signature Shipment Date Driver Signature Del+very Date CEEMEM 'rte Name 8 P I Vasco Roaa Landfill Phone No 4001 'forth Pasco Rd Livermore Ca 94550 ddress hereby certify that the above named material has been accepted and to the best of my �wledge thelforegoing is true and accurate / r r � f Authonzed Agent Si nature �� Receipt Date ' PASS CODE 10186 SF1260 720