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1 C r-C� <br /> Waste No. 7 9 8 0 S U <br /> :.FERRIS tNDUSTflIES Systems T� <br /> TM <br /> -FNON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> C38r{k of Si.oGIS%Or3 <br /> Generator Name Generating Location <br /> P. 0 . Box 1110 <br /> Address Address <br /> Stockton , Ca . 91 E 2 0 I'St :moon CE . <br /> 2 0 9 — <br /> Phone No. 7Phone No. <br /> 5,,.� A Q C L 1 v ( � l_ <br /> BFI Waste Code � 1 Containers Type <br /> Description of Waste QuantityUnits No. Type C- Drum <br /> F m C-Carton <br /> S � p^rse <br /> I Cc.ntminatd Sc,il B- Bag <br /> ❑ m ❑ T -Truck <br /> P -Pounds <br /> Y-Yards <br /> Elm El <br /> 0 <br /> -Other <br /> I- ! <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 CFA Part 261 or any applicable state law, has been properly described, <br /> classified and packaged, and is in proper cond <br /> iti <br /> o <br /> n for trhnsportatio 'according to applicable regulations. <br /> Y `� <br /> Ronald K, R-irlehr- <br /> at , <br /> G ator Authorized Agent Nam* Signature Shipment Date <br /> TRANSPORTER <br /> Truck No. Phone No. <br /> M ;v <br /> .P Environmental Ssices <br /> Transporter Name Driver Name (Print) <br /> '3400 Manor Street �fQ <br /> Address Vehicle License No./State ` <br /> Bakersfield , Ca - 93?03 <br /> Vehicle Certification, <br /> 1 hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the generator site listed above. out i idem to the destination listed below. <br /> Driver Signature Shipment Date Driver Signature Delivery Date <br /> , <br /> DESTINATION <br /> Site Name Vasco Road Sanitary Landfill - <br /> Phone No. �^ <br /> Address 4001 Vasco Road , Live-, more, Ca : 94550 <br /> I hereby certify that the above named material has been accepted and to the best ofAy knowledge the foregoing is true and accurate. <br /> ti <br /> 111M <br /> Authoriz*d A ent Signature / J/ Re6ei t Date <br /> AUU W MUL / <br /> ENVIRON MEN?q'L95ALTH PASS CODE <br /> PERMIT/SERVICES <br /> B Ft26oa2o <br /> TRANSPORTER RETAIN ` <br />