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R■G �.7�� FI Acct- Vo. 1009042c No <br />' Systems TM <br /> OWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> r @ . <br /> 1\11ld Cal i easing I4 C r'f~anI � ,r <br /> =, nerator Name Generating Location <br />'' G Box E6103 Stockton Ca <br /> Cdress Address <br /> 15205 <br /> tone No �— Phone No <br /> 1 7 1P 3 ' 7 3 <br /> Fl Waste Code � Containers type � <br /> Description of Waste Quantity Units No Type D - Drum <br /> �r C Carton <br /> _T_ <br /> a ir' r l.-+CC4 1 t .-.__ B Bag <br /> T Truck <br /> ❑ �� ❑ P Pounds <br /> Y Yards <br />' ❑ ❑ O Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR fart 260 10 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CF11 Part 261 or any applicable slate law, has been properly described, <br /> classifted and packaged, and is in proper condition for transportation according to applicable regulations-j <br /> aerator Aulhonzed Agent Name Signature Shipment Date <br />�uck No ! �r� Phone No l 63 L i 5 <br /> nsporter Name f~i EI�. �onrrlenta Sir, f7 = <br /> Dever Name (Print) ���+ _r�.'. <br /> 4110 Manor Sr-r`c-er- <br /> dress Vehicle License No(State <br /> C& y 3 3 0 P <br /> lI Vehicle Certification <br /> ereby certify that the above named material was picked up !'hereby cerfify that the above named material was delivered with- <br /> t the generator site listedabove 'out incident to the destination listed below <br /> Iver Signature —��� Shipment Date / Driver +gnalure Delivery Date <br /> i <br /> `v`a-3co Road Sanitary Landfill - 0 — 4 7 t7 $ , <br /> Name _ - - Phone No <br /> r. 1 , d: wCG F'C= _L . L '� �?rirlvl,= , C_ �i<: :r.iC <br /> ddress <br />�reby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> EII:= <br /> Authorized Agent Signature Receipt Date <br /> PASS CODS <br /> 8F}260 7Za <br /> GENERATOR RETAIN <br />