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Waste No. <br /> Systems TM <br /> BROWAIING-ORRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> i {-`i0%�L �lar�ptlz2 i.�;QC.�i S� :t�3ti t$9w1 <br /> Generator Name Generating Location <br /> 0 <br /> Address <br /> 4-1-37 Address4-1-37Oacifar ; <br /> San Ramon 04513 S_0t;x <br /> � t -, 1 <br /> _ <br /> Phone No �^ Phone No <br /> -1 _ 3 2 1 1 Containers Type D- Drum <br /> BFI Waste Code - <br /> Description of Waste- Quantity Units No T <br /> ❑ r�I C-Carton <br /> B - Bag <br /> I � .gars `spa:coos CUs; El <br /> m 1:1 <br /> T -Truck <br /> P - Pounds <br /> YRS psi?- 8i^> Y -Yards <br /> El <br /> m El <br /> O-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 proper condition for transportation according to applicable regulations <br /> L 4t* r ' Jt r -A <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> Truck No ti Phone No <br /> Transporter Name Driver Name (Print) <br /> ;JG =1430, 11) _ tt <br /> Address Vehicle License No/State <br /> 5—ran Cai�,z?rnia 34514 - <br /> Vehicle Certification <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the generator site listed above out incident to the destination listed below <br /> 1 <br /> Drw Signature Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> 1 Site Name Phone No B-F.I Masco Road Landfall 5 0 — 1 -t 7 1 0 4 <br /> 4001 Borth Vasco Rd L34ermore --a 94550 <br /> Address <br /> I hereby testify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> 1 <br /> of Authorized errs Signature Receipt Date <br /> PASS CODE <br />' lam eF1260.720 <br /> /� TIf=O AT/'►1'1 f-11- A1k1 <br />