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Forward AoorOVGl Nuxber: =$29F1 SPC4323 <br /> e�wri o. a Pro, I to. . <br /> 1. Generator's US EPA l0 Na. Manifest 2. Page 1 <br /> NON-HAZARDOUS D cement No. ' of <br /> WASTE MANIFESTS ' <br /> 3. Generator's Name and Mailing Address <br /> Fiestana `.l.'rTust <br /> 1431 3tteburry Lane <br /> 4, Generator's Phone( ) San Jcse, CA 95131 600-74--744 <br /> 5. Transporter 1 Company Name 6. US EPA ID Number <br /> Co-nti Material Service . . . - <br /> 7. Transporter 2 Compony Name B. US EPA SD Number <br /> 9: Designated Facility Nome and Site Address 10. US EPA 10 Number A. Transporter's Phone <br /> ForwarC inc. B. Transporter's Phone <br /> v. 30Y Cil 3 3 U {{ f�{f ` C. Facility's Phone } <br /> Stockton, CA 95207 <br /> 12. Containers 13. 14. <br /> 11. Waste Shipping Name and Description Total Unit <br /> No, Type Quantity Wt Vol <br /> a J <br /> -Z;c,i1 'r7: th -c2tro urrm, r1y6rocarl= <br /> G b. <br /> E <br /> IN <br /> E <br /> R <br /> A Cr <br /> T <br /> O <br /> R <br /> d. <br /> 0. Additional Descriptions for Materials Listed Above E. Handling Codes for Wastes Listed Above <br /> 15. Special Handling Instructions and Additional Information <br /> 16.GENERATOR'S CERTIFICATION: 1 cert,iy the materials described above or this manifest are not subject to federal regulations for reporting proper disposal of Hazardous Waste. <br /> Printed/Typed Namr <br /> i hature month Day Year <br /> if <br /> T 17.Transporter 1 Acknowledgement of Receipt of Materials <br /> R rinte ed Name -t re Month Dar e_ar <br /> A <br /> S ✓ S //fes-�/�J�+� ? <br /> P <br /> O 16.Transporter 2 Acknowledgement of Receipt of Materials <br /> R Month Do Year <br /> T Printedt'Typed Nome Signature r <br /> E <br /> R <br /> 19.Discrepancy Indication Space - <br /> F <br /> A <br /> C <br /> I <br /> L 26.Facility Owner or Operator:Certification of receipt of waste materials covered by this manifest except as noted in Item 19. <br /> 1 <br /> V _ i nature _ Month Day Year <br /> 2Printed/Typed Name <br /> e 9 <br /> TRANSPORTER #1 <br />