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No ! 980 '? 7 <br /> Systems TM <br /> OWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERA TOR <br /> F <br /> Generator Name Ban", Uf 5toc kto- <br /> �.� <br /> Generating Location <br /> Address - �'ox 1 1 7 0 1 ,112 !N We L-r <br /> Address <br /> Cc ` T _, l <br /> c .� 3 ? 7 <br /> Phone No J Phone No =—F I Waste Code EUI = <br /> Containers Type <br />' Y <br /> Description of Waste <br /> Quantity Units No T e D- Drum <br /> t?r,- <br /> roti S - ' El::]= ❑ m _ C- Carton <br /> B - Bag <br /> E:E= El0 I I J T -Truck <br /> P - Pounds <br /> YF. - Yards. El:= <br /> ❑ m 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 /> 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 propel oondition f transport$tian according to applicable regulations <br /> Generator Authorize/Agent Name Signature <br /> Shipment Date <br /> TRANSPORTER <br /> Truck No Phone No <br />[Transporter Name M P cnv?rcmmenta 7 St=r „ -ices <br /> Driver Name (Print) <br /> r <br /> Address 3a0Q Manor st-eet 42�U <br /> Vehicle License No/state <br /> 3akersfield , Ca _ 93308 <br /> Vehicle Certification <br /> 1 hereby certify that the above named material was picked up I hereby certify that the above named material was celivered with- <br /> 'at, <br /> ith- <br /> at the generator site listed above out incident to the destination listed below <br /> Driver Signature <br /> Shipment Data Driver Signature EKE <br /> Delivery Date <br /> DESTINATION <br /> LteName Va``-a Rcad Sarsitary Landfill <br /> Phone No 7 0 - <br /> ddress 4001 Vsscc Rinse , L' .errricre , ca _ 04450 <br /> hereby certify that the above named material has been accepted and to the best "y ledge the foregoing is true and accurate <br /> ON* �!Authorized A gni Si nature <br /> Recei t Date <br /> PASS CODE <br /> 10188 <br /> ' BFI260 720 <br /> TRANSPORTER RETAIN <br />