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y -_ - '..:ste No r s$ o 0 <br /> 4 <br /> systems tm <br /> nIG-FERRIS INDUSTRIES <br /> NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> 01i a <br /> • <br /> 4ar-l� oL P�ork`c� ('la`.-�i13 t]iwZrrit;ut7.5 <br /> Generator Name Generating Location <br /> $ " O- Pax 1110 11. d9 W_ ',* bor <br /> •Address Address <br />' Phone No �— ^ <br /> Phone No <br /> BFI Waste Code [ED �] Containers Type <br /> De---on of Waste Quantity Units No T e D- Drum <br /> Esc-1 �cr�3r)- nmt�d sc,II � � �`�� C- Carton <br /> IDELI B. - Bag <br /> ❑ _` ❑ T -Truck <br /> WP - Pounds <br /> Y -Yards <br /> ❑ -`� ❑ 0-Other <br /> i I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 for 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 transport tion according to applicable regulations <br /> ! 1 t <br /> d Kne'�ar� � t <br /> Generator Authorized Agent Narne Signature (t Shipment Date <br /> TRANSPORTER <br /> 4 <br /> •Truck No �� '1 <br /> �� Phone No <br /> Env?rortmental Servicers --> <br /> Transporter Name M Driver Name (Print D <br /> 3400 Manor Street <br /> ddress Vehicle License No/State <br /> Bakersfield , Ca - - 933ce <br /> Vehicle Certification <br /> hereby certij that the above named material was picked up I hereby crtify that the named matenal was delivered with- <br /> at the ge fator site lisle bove out Incident to the-dest atton listed below <br /> r if= <br />' <br /> Driver Signature Shipment Date Driver Signature L pellveryDale , <br /> DESTINATION <br /> \ <br /> 1 - <br /> !SiteNameVasco Road Sanitary Land-gill 5 1 a 49 M <br /> Phone No �— <br /> 4001 Vasco Road , Livermore, Ca _ g�CEEO <br /> YAddress <br /> 1! <br /> hereby certify that the above named material has been accepted and to the best of m o edge the foregoing is true and accurate <br /> 'Authorized Aent Si nature Rsoel t Data <br /> ` PASS CODE <br /> 4iUE8 <br /> } BF1260 720 <br /> • TRANSPORTER RETAIN <br />