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r <br /> .NQ. _,a0g0az 907-99S-_- <br /> Systems TM <br /> PROWNING-IFERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> INDUSTRIES <br /> a � . <br /> _Mid Cal Leasing 1u49 E +�t)annel St . <br /> enerator Name Generating Location <br /> P C Box rp 510 3 _ Stockton , Ca <br />�ddress Address <br /> ..4tOn , Ca . 95205 <br /> 4-115 -r I <br />'hone No - Phone No — <br /> 1 _E1 <br /> Containers Type <br /> 3F1 Waste Code r, r 1 p - Drum <br /> Description of Waste Quandt Units <br /> No Type <br /> C - Carton <br /> Di esal Cont:atni nat:ad .moil l B - Bag <br /> T -Truck <br /> ❑ W ElP - Pounds <br /> Y -Yards <br /> ❑ (� ❑ O Other <br /> 11 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 t`sportatlon according-to applicable regulations <br /> �onal � K _ � Fm <br /> L ;, _ <br /> nerator Authorized Agent Name Signature Shipment Date <br /> 0 <br /> x "k <br /> - 9 i 6 b h 3--'3^_ i G <br /> luck No -4--77 Phone No <br /> MP Environmental Spry,cep _R5� <br />'ransporter Name Driver Name (Print) , <br /> 1-1C, Manor Strut _01fL_1J�- <br />[dress Vehicle License No ISt <br /> lereby <br /> o <br /> r_f ipla Ccr .?: i1� Vehicle Certification yj certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> it the generator site listed above out Incident to the destination listed below <br />,river Signature w Shipment Date Driver Signa ure Delivery_Date <br /> • <br /> �I���o g'crad San-nary Landf-T� l 5 ' � � - <br /> e Name hone No <br /> 11001 Vasco Road 1_i ve rmnne Ca Gd 550 <br /> dress <br /> ereby certify that the above named material has been accepted and to the bfst of my knowledge the foregoing Is true and accurate <br /> Authorized A ent Signature Receipt Date <br /> PASS CODE <br /> 6 <br /> BF1260 720 <br /> GENERATOR RETAIN <br />