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• I <br /> Waste _ 691560 <br /> Systems T <br /> tt PIG-FEFUUS INOUSTMM NON-HAZARD(�QS SPECIAL I PASTE MANIFEST <br /> Inerator Name ExxOD Companq U S Aaenerating Location s xa�tatin>n *7-3330 <br /> Egress P O Bog 9435 Address 3128 W Benjamin Holt Dr <br /> Houston Texas 77314--4415 Stockton California <br /> 5 I 0 -�2 4 fi 8 — �- <br /> )one No Phone No � <br /> mWaste Code FT71 EII= - Containers Type <br /> Description of Waste Quantity Units �No / T g D Drum <br /> -- 1=0 1 8 f I/� 8-Boson <br /> SOI HAZARDOUS `_—`f_'� 7 .Truck <br /> SOIL L ❑ ❑ P. `funds <br /> y Y-Yards <br /> Em ❑ 0-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 applicdble <br /> state lave, is pot a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been property described <br /> classified and packaged, and is in proper condition for transportation according to applicable regulations <br /> Au ed Agent Name Sgtiahrre Shipment Date <br /> ruck NoPhone No 510-634-6850 <br /> r sporter Name Dillard Trucking Inc 2/50 _ <br /> Driver Name (Print) <br /> ddress F 0 Hoe 218 Vehicle License No/State <br /> Bvron California 94514 <br /> Vehicle Certification <br /> hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with <br /> i e generator site listed above out incident to the destination listed below <br /> 1 J <br /> Signatu Shipment Dale er ign a Delnery Oate <br /> r s <br /> Name— ,„ , r, "I r- 11 - <br /> — Phone No ' — I 11] <br /> ,driress <br /> �,,-"v certify that the above named malerial has been accepted and to the best of my know tedge the foregoing is true and accurale <br /> .nn of AuthOnled A ent <br /> � _ Si Oaiure <br /> -� Receipt D?iP- -_ -- <br />