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f No. 916 <br /> 2 3 <br /> S]%� '1S " NON-H �ZARDOOS SPECIAL WASTE MANIFEST <br /> ' <br /> ST S <br /> GENERAT <br /> BROWNING-FERRIS INDUi <br /> • <br /> i`tJ �ivl PI?_?DLC7 S R sFTunr= ,;T�.rv, <br /> Generator Name Generating Location <br /> SAME4 <br /> =:Address 450 E. GCNE ROAD Address <br /> TRACY, CA ` 95376 same <br /> Phone No.' 2 0 9 $ 3 5 9 1 3 3 Phone No. 2 0 9 —8 3 5 9 3 3 <br /> BFI Waste Code f� O S f s!j Containers Type <br /> Description of Wast `'J , t ? Quantic Units No. T e D - Drum <br /> DEC .C-.Carton <br /> �1QSe1Llv410, 92' <br /> i 1 r` � d I' B Bag <br /> v <br /> E 1:1T -Truck <br /> {�VIi'li:'s :uEd�! `s i��,j ,­ -:?T '� P - Pounds <br /> P AMf���SERViCE5 Y -Yards <br /> Em0 Other J <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 con ' ' n for,tr sportationnaccording to applicable regulations. <br /> _---. DM FAGUNEES, PLANT MUM= ko_ ({4j 6L` ( U <br /> Generator Authorized Agent Name Signature Shipment Date <br /> r <br /> Truck No -% - Phone No. <br /> 1 <br /> Transporter Name she 5 _G Driver Name (Print) �e5 <br /> / I <br /> Address /f -� Vehicle License No./State Zo'T r)- 8- <br /> t <br /> Vehicle Certification <br /> I herebycertify that the above named material was <br /> fy picked up I hereby certify that the above named material was delivered with- <br /> at the generator site listed above. out incident to the de tin tion listed below. I <br /> [210 16, <br /> D r ignature :.. Shipment Date river Signalbre Delivery Dale <br /> DESTINATIONo <br /> i <br /> Site Namek <br /> Phone No. <br /> Address ' <br /> I hereby certify that the above named material has been accepted and to the bes of y knowledge the foregoing is true and accurate. <br /> ` kthoriied Agent r' <br /> Vamr SE nature <br /> Racei t Date <br /> PASS CODE <br /> 10/86 t <br /> . BF1260.720 <br /> -: <br /> 'UNLOADING OADING AREA COPY . <br />