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r 1 r <br /> ire No 7980.33 <br /> .r�GFFJyStE'!'17S TM NON-HAZARDOUS r� RDOUS SPECIAL WASTE MANIFEST <br /> enerator Name Bank cr c;ozkytor <br /> Generating Location ' <br /> dress P L'- ecx 1 1 1 p " 49 N +N=be.r <br /> It Address <br /> W`_cckton , Cm 95202 ^- --_1 <br /> , L <br /> rone No 9 � 2 3 7 Ij <br /> Phone No <br /> 3F! Waste Code EE <br /> li= ContainersESag <br /> Descri tion of Waste Quandt Units No T e <br /> =s�1 Cor 4,sn'r,�t� c� ? ❑ m <br /> ETI= ❑ ❑❑ ' <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 I <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been property described, <br /> classified and packaged, and is in proper c'bndition for transport tion according 10 applicable regulations <br /> I <br /> R nand K RInah&"t t <br /> 1 <br />�nerator Auttrorized Agent Name -7Signature <br /> Shipment Date <br />[porter <br /> No f— b(�� <br /> Phone No <br /> Name M P Enviranr-_-n �a ? er„ 9cas9— <br /> Driver Name (Pant) <br /> ss 3400 Manor Street <br /> Vehicle License No/State <br /> eakersfia?d , Ca - 933^$ 3rP 7 � <br /> Vehicle Certification ,. <br /> Vature that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> r site I ed above out 1 ent toWthede'salio listed below , <br /> F Shipment Date Driver Signature <br /> Defhrery Date <br /> tme Vasco Pond Sanitary Landfill , C <br /> Phone No =—I <br /> a , <br /> S <br /> 4001 Vasco Road , L34Ernnre , Ca . °4550 ' <br /> eby certify that the above named material has been accepted and to the best of my k o�pdge a foregoing is true and accurate <br /> 4 � EaALq gni Si nature <br /> 1 Ree 1 Dat <br /> PASS CODE <br /> eFizso 720 <br /> TRANSPORTER RETAIN <br />