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- <br /> �=,-� 79825N. , <br /> as4e'={r v No <br /> � M � V <br /> r ,�3 .w 4 <br /> y � �� , . r <br /> G-FERRIS INpUSTRIES l; NON-HAZARDOUS-,SPECIAL,WASTE, MANIFEST <br /> �, ..�„•t,Y- , x.�+nc,....G �S," rr\F.rM Tq i �J 21< ei __ ♦ a ' _ - iif <br /> Yy'� "' �Y 13 'bkas 01stributan ir�9s= <br /> ator Name= `r - Generating Location 1 _ <br /> `3 W. Weber <br /> Bax, 11D' � - <br /> i^ <br /> reqs' Address ! <br /> „ , <br /> ` , 95209 Stocictpr�,_ Ca. <br /> Stockton,° CaE - r r _ <br /> one No =—FTPhone No <br /> FTFATJ FT µ " Containers Type <br /> Ivaste Code D-Drum <br /> Description of Waste Duant+ Units No. T Te C-Carton <br /> , gF' Diesel Contaminated Sail 13 .6a9 <br /> I T -Truck <br /> ` ❑ m ❑ P,Pounds <br /> Y-Yards <br /> Elm ElO-Other <br /> 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 /> ctate law, Is not a hazardous waste as defined by 40 CFR Part 261 or anyy applicable state law, has been properly described, <br /> lassified and packaged, and is in proper condition dr,transport:at n acco`di to applicable regulations <br /> ftrrnald} tH <br /> K �'Rir�ehart' ; <br /> uthortzed!+ , " shipment Date <br /> Wo <br /> Alf, �4 i <br /> '7 �,yn •g °• " i�, tK,�y �.``�, ` r3 r-, ' ," .?' Y..� �"' s T <br /> Phone No. � r: <br />�' *il�� a � . r�",[7i'�+xr:y � Y".a-=k: '�`��r� �, ♦ A r y„x� <br /> �' _ �l:nv. Oftme>,ta��i�,Sa��ires ,�4L�n� ��",'� t��<`'•L'��" Y�<J t t1/�r� c � y,`s tib_ <br /> Driver Name(Print) <br /> a i3baO }Nenar11'St eet' � k r `: _NoJ[TSNtaNte <br /> ldresa - Vehicle <br /> �,[ <br /> �Skaa ''+!�"' • 30t3 w_ t' •Y7o^a.t �F1A , � � �s'<:^¢ � �tY• <br /> s wr: : .�',�. s ,„Y7YZ' raw�F�S- rr 1,.-„�' •6 N„v y.- 7 <br /> # Vehicle,C rtifiCation 4- , <br /> tereby certify that the above named materiel was picked up i hereby certify�that the abov-0eynamed_material,was delivered with--, <br /> �enerator site listed aboire. - 'mow ~'ut nctd n Bio theme destinab? listed below ,� y � <br /> ' ; tisk <br /> [y ,O" ' r�ti 'r" 4 t°� ;.x"� w .r•�• l ;I�}r(•�- 'k' F40_ <br /> t �} 'y , <br /> wr 8M1a1G�as w I1W t4_ F II �+jjeTWdC Date Driver S�naturo� JJJ � y gel ry Dats' - <br /> P �" *Y SIN Yt f <br />� 1 4�7 +� '`I'r 1.C.'�,.nY y' ', <br /> DESTINATION <br /> 4 <br /> ; aSCt3', RO SZIs�r ��tj,'.7�k'"�� ' � y�'�t�� P.- <br /> z'. Phone No. <br /> e Name a,r <br /> �f' �' ..1C]c�rt 3' ti0t� t°i `F vSv1 �+..;si�+' t: .'w4v.� �..-.�t, KYR r xr��Y•`. �r� y � � <br /> ", .�� Crt��; 5�15503•�.���,o�+f�a:�„r,�,'�W-r f�� ������. �-. � •w''� <br /> ' _ d� Qi�3dc�- V <br /> ddre +�+ ar_ <br /> _� 1cwyrcoa�.z.+.r tet. <br /> lr� iS. moi. xW+,l Ni; V Wi-:,W �� !•Y�a4r'� .S�' <br /> ereby certify that the above named materialc�h�aas been accepted and to the best o nowled a the foregoing is true and accurate <br /> JtZY, ,+ Ff-,A N*y <br /> E�.'7"" � „ �` sr. +�" .� tr����.�, r;�_r!'�a ii"y is i. w•».�F�r w. "'e � w� <br /> A�u�tho�rized A Ord � •,R�-,.j • }=T - - Si nature - r� - Rs Date <br /> ~ '"4'f �sr'-��i!' a��`• '� � ti�r'+ly�kr���"�'�"� ,�s*�•�A�t -r �, 7~rte _ 3`i etj,rt� <br />� i� .'h A + +1...i'ti �� ti yrY.0 ..M',at•'' T�'}Y^ �Y�� aft`+YY •,.X.9- , �.j <br /> PAr <br /> N <br /> pit <br /> [ �{.��Ey r�U 'F1 <br /> ` r <Yn w Rrc r�r�a7'rr] RFTAti�f - .• - � .•, -•�' ` - <br />