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-ate No f 9 S 01. 8 <br /> ' �E.Jystel'11S TM NON-HAZARD <br /> 4US SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name <br /> Generating Location <br /> S Address <br /> Address <br /> _EE <br /> 1 7 T <br /> Phone No Phone No <br /> ' BFI Waste Code - - r <br /> Containers Type <br /> Desch tion of Waste Gtuantit Units No T e D- Drum <br />' Cart_ rpt rc ? C- Carton <br /> m B - Bag <br /> ❑E17 ❑ T -Truck <br /> P - Pounds <br /> Y-Yards <br />' EII= D m ❑ O-Oilier <br /> hereby certify that the above named material does not contain free liquid as defined by 40 CFA 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 ffran sportatio accordit g to applicable regulations <br /> Generator Authorised Agent Verna Signature - r <br /> Shipment Date <br /> Truck NoxC9 <br /> A Phone Na I <br /> MP t=r,v� rorrrer, � �1 Serrirs-- ff <br /> Transporter Name Driver Name (Print) <br /> Address :'400 Manor Street <br /> Vehicle License No/State <br /> eakersfie'd , Ca _ 9-113108 <br /> Vehicle Certification <br /> II hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> al tF}e generator site listed above { out loCident to the destination listed below <br /> L/ -'O�d r""' <br /> Driver Signature n ti. �— <br /> Shipment Date Driver Signature f Delivery Date <br /> t . 0 <br /> Sfte Name <br /> PN!asco Rosd San7ta--y t_i;nefi 11 <br /> Phone No �— C <br /> Address 1 VA9co,a_Fca� , Li . errno-s <br /> tr <br /> rl hereby certify that the above named material has been accepted and to the best of my knowledge th tforegoing is true and accurate <br /> f <br /> i Authorized ent <br /> Signature <br /> Receipt Date <br /> twee <br /> PASS CODE <br /> s <br /> TR BFi260 726 <br /> x <br /> TRANSPORTER RETAIN <br />