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iaste No 798021 -FERRIS TM NON-HAZARDOUS SPECIAL WASTE MANIFEST IF GENERATOR E�,nl - r t:.� c..- I - ,nerator Name `� on �.3bka 7 =t r, bL-w ;-c Generating Location �. ucY ' 1 � � 7 t 4Q 114f+J��rT Address Address 1 r.-acl, `::�n ' Ca cE:1 7 �l Phone No v o A Phone No 1 i r BFI Waste Code y - - Containers Type ' Description of Waste Quantity Units No Type D - Drum ^ J 1 m � C- Carton B - Bag ' ❑ m ❑ T -Truck P - Pounds Y -Yards El:= Elm ❑ 0-Other ' I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 or any applicable state law, Is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been property described, _ classified and packaged, and is to proper condition for trhnsportation according to applicable regulations _ Pl ne .8- Generator Authorized Agent Name � S .. r S�gnalure Shipment Date TRANSPORtER ' Truck No Y` I Phone No Transporter Name M P Fn - t rcr man l-s1 4 Driver Name (Print) Address 3400 Mann, Strce , Vehicle License No/State Z= )"r/ Sakcsrsfjeld , Ca . 93308 r Vehicle Certification 20Z H(" U I hereby certify that the above named material was picked up I hereby certify that the above named material wa., delivered with- at the generator site listed above out incident to the destination listed below f t Y river Signature Shipment Date Driver Signa ure Delivery Date 7 DESTINATION ` Site Name�asc� Rc�sd 5sn 7 tar? Landfill Phone No Address 4 00 1 Vascc Pcad , L i ve-mzcre ; Ca o4 = 8 I hereby certify that the above named material has been accepted and to the best f m" y knowledge the foregoing is true and accurate 1 1 / Authonzed A en( Si ndtu e a 4, f i Receipt Dale - PASS CODE i0l86 J. , BF1260 720 TRANSPORTER RETAIN