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rf r <br /> NON-HAZARDOUS SPECIAL WASTE & ASBESTOS MANIFEST <br /> If waste is asbestos waste complete Sections I II tI1 and IV <br /> If waste Is hQj asbestos waste complete only Sections t II and III NO• 907634 <br /> Z w GENERATOR (Generefcw r` t♦teTSection n <br /> s Generator Name -`\Ertl ua„+A n. I S A b Generating Location e,ti„[t t I r 1 , = 7-3708 <br /> Address �C) [l t >Uv Rai f2L141tnatIun ,lt <br /> d Address ,701 coullltt ,"luh BIN'd <br /> Ili"t.tvil T% -^,2: -2.1fit. <br /> Stur }ttUn [ , <br /> t Phone No ;, t f Phone No t <br /> I owner of the generating facility differs from the generator provide <br /> I OwpersName r.\"[ 1 f-uhlrr,urr L 5 A h Owner's Phone No ""fat a- Ifs <br /> BF!WASTE CODEs 7 r, K=-" <br /> tJ t ,, ^ IYEE <br /> Containers DM META(_DRUM <br /> 'tDP PLASTIC DRUM <br /> Description of Waste Jll tlr r[tint[ So i 1 k Cluanti units No TYPE BA SAO MIL PLASTIC BAG <br /> or n t} r, 1 T TRUCK <br /> O OTHER WRAP <br /> GENERATOR S CERTIFICATION I hemby certify that the above named materiel is root a hazardous waste as defined by 40 CFR Part 261 or <br /> any 40;0k'We stale law has been property described classified and packaged and Is Fn Proper cotdrttcn for transportation accord! to UNITS <br /> applicable regulations AND It the waste iia bsatment residue of a Pmvlouety restricted h"Ardous waste sublect to the Land Disposal Y POUNDS <br /> Restrictions t tarty and warrant that the waste has been treated in accordance with the YARDS <br /> hazardous waste as defined by 40 CFR Pan 261 red of 44 GFR Par 269 and is no longer a M' CUBIC METERS <br /> �t the r-l,,,,, ,•f E,tion cry c Y' CUBIC YARDS <br /> a r O OTHER <br /> r / <br /> Generator Authonzad Agent ame 1 Signature <br /> Shipment Data <br />,ectltm II � z' t4 s�yC, 4 f TRANSPORTER 7raneponeri ate <br /> Gensrappr domplete sick iter>a <br /> TRANSPORTER I TRANSPOATI=R II <br /> Name 11 i ' 1[ I T r'k1r,g Inc <br /> h Name <br /> Address a � _1 8 <br /> Address <br /> Diner NaunaTitle , y- _ r <br /> APOwledgement <br /> No iA jrl PRINT RP I Driver NametTtle PriINTnVPE <br /> a Truck No l k Phone No I Truck No <br /> Lk ens.NoJStata 1 ' --' < 1 - m Vehicle License No./State <br /> of Receipt of M is - Acknowledgement of Receipt of Materials <br /> �� i <br /> F � <br /> n 1 <br /> DArar 8 taro <br /> action 1IIr <br /> 5M Day <br /> +tDE [��TIO e"3'a �aom cr y*y�r <br /> SrteName 1�Tt'as( u Rr1 L,irrrfr113 tis01 j17-p1UI <br /> c. Phone No <br /> Ir,rli a-_r Pr+t,l <br /> Physical Address nt ,h 1d Melling Address 1001 N"t tit 4r�,(n Roltaf <br /> zttr [Mot t- c 91 1,0 11"ermolr CA 94350 <br /> Discrepancy Indication Space <br /> I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> Q <br /> varr,a or,Wnnar,:w Ager slgnaoae r'f)= tl--20"�I <br /> Recelot Dau <br />)ctlon IV "ASBESTOS-(Generator complete ad,f-g Operator- <br /> Operators <br /> peratorOperators Name b Operators Phone No <br /> Operators Address r <br /> Special Handling Instructions and additional information <br />_BATOR'S CERTIF3CATION I hereby declare that the contents of this consignment are fully and accurate) descnbetl above b <br /> ted marked and labeled and ora to all res y y proper shipping name and are classified l <br /> pests to proper condition for transport by hlgnway according to applicable international and government regulations <br />)perators Name&Title <br /> ELIP+vtt/Typa parstola S,gnaturo pay I <br /> lame and Address O `I <br /> if Responsible Agency <br /> I <br />] Friable ❑ Non friable ❑ Both %friable %nonfriable <br /> O r refers to the company which awns leases operates controls or supervises the facility being demolished or renovated or the demob ion or r v <br /> ono atron operation or both <br /> NLY THROUGH BFI I UARCO CONTRACT <br />