Laserfiche WebLink
y <br /> '. � r ia,` -.t i F v 4--„. <br /> rx r i • riR <br /> I. fl�EI SAL ENVIRONMENTAL— <br /> '0 { � <br /> P,O BOX <br /> .996,'-BENICIA,CA 9451Q,{707}747-6699 <br /> NON-HAZARDOUS 'SPECIAL WASTE. MANIFEST <br /> GENERATOR <br /> Generator._Name” :'eredi Trav c t at i'ou Generating Location Sates 1 <br /> Address 9bn ,.Rd Address <br /> _171 <br /> Phone N ' '' . <br /> o. Phone No. <br /> j Containers Type <br /> Descri tion of Wasteuantity, Units No. T e D Drum <br /> C' Carton <br /> © � B Bag <br /> Cot"t'tamis ped SoilWf tl~ Fuel. +x oil .' # T =Truck <br /> i. El 0:10 P-Pounds <br /> _ Y-Yards J <br /> R <br /> m .a O. Other;` , <br /> hereh cerci <br /> the <br /> tthea <br /> Dove <br /> Y named mate" '. , .. fY aE does not n <br /> co fain free li uid as defined b 4 <br /> q y., 0 CFR Part 260.10 or any applicable 1 <br /> state law, is not a hazardous waste as defined by 40 CRR Part 261 or any a'plicabie state law, has been properly described, <br /> classified and packaged, and is in proper.condition for transportation accordirito applicable regulations:' y� <br /> ,f 1 <br /> i ,f - • '�� �1.`�f� E - - <br /> Qsnerator AuthorirQ Agent Name Signat Shipment Date , <br /> " . <br /> i <br /> c TRANSPORTER <br /> j Truck No. Phone No: ?tib 7ja` tifi ; <br /> Transporter Name Uni'Ve1 val -1 nvir'onkayFt:'e.3 <br /> Driver Name (Print) <br /> Address 9=.f98 Par nd Vehicle License,No/Stated 1. r s. !7 r <br /> is <br /> Ranie it'. :� G 110 Vehicle Certification <br /> f 'I hereby certify.that the above named material was picked up 'I hereby certify thaC thel above named material was delivered wish <br /> t <br /> at the generator site listed above. out incident to the destination listed below. <br /> Driver Signature Shipment Date or Signature Deii,rery Date <br /> DESTINATION { : k <br /> Site Name Forw d Lalidf ill - Phone No. � Q 9 — �C Ci 1 & 4 4 6 2 <br /> Address 14W r <br /> „e Chartor Way, St:ur.ltta:a, CA 9506 <br /> LE <br /> I h, ,y certify that the above named material has been ecce d and t e DesAIIT of.m <br /> f/ f, ,� Y lc+ibw!e a the fq" g is true and accurate <br /> Nan»of Aulhoriied SI nalura Recei t ate <br /> i <br />