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7 4�5­ <br /> Waste No. 79 Q 0 IF 5 <br /> 0-Systems TM <br /> BROWNING*ERRIS INDUSTRIES <br /> NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Bank .ofStockton WRSt2rn Lift <br /> Generator Name <br /> Gpneratin'g,Location <br /> P_ 0 . Box 1110 2430 S_ E! Dorado <br /> - Address Address <br /> Stockton , Ca - 9520 ' S t 0 C k t a n , C <br /> Phone No. Phone No. <br /> 11 FContainers.-T 1 1 1 I in 'i Type <br /> er <br /> BFI Waste Code <br /> Description of Waste Quantity Units NO. T ype0 Drum <br /> T - <br /> L; Carton <br /> IQ m T <br /> i B - Sag <br /> i ❑ m ❑ T -Truck <br /> P - Pounds <br /> Y-Yards <br /> er <br /> 0-Oth <br /> El L I E -_­�' <br /> i. I 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 foiTransportation accordin" g to applicable regulations. <br /> Ronald K_ Rinehart <br /> •-Generator Authorized Agent Name Signature Shipment Dais <br /> TRANSPORTER <br /> 11 <br /> Truck No. ✓ Phone No. <br /> M P Erivilronmental Services <br /> Transporter Name Driver Name (Print) <br /> 3400 Manor Street <br /> ddress; Vehicle License No./State <br /> 12 <br /> 9, 13308 <br /> Bakersfield , Ca . S Vehicle Certification-_,(, C <br /> .1-hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> V <br /> at the generator site listed above. out Incident to the destination listed below. <br /> Qrivsrfisiginawre I V7 Shipment Date Drtyar Signature Delivery Date <br /> DESTINATION <br /> Vasco Road Can 1 ta ry Landf i I I P <br /> Site Name Phone No. 1 r 1 1 <br /> Address 4001 Vasco Road , Livermore , Ca 9455t' <br /> I hereby certify that the above named material has been accepted and to the best of my-knowled e g"t 94"ve-and-awurate—_ <br /> 2 <br /> RECEIVEW <br /> Authorized Agent Signature <br /> A U IJ <br /> ENVIRONMENTAL HEALTH <br /> PASS CODE <br /> PERM ITYSERVICES <br /> 0186 BR260-720 <br /> TRANSPORTER RETAIN <br />