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Waste- : . . No. 916025 <br /> Systems.TM 'NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> BROWNING-FERRIS INDUSTRIES NON <br /> GENERATOR <br /> Generator z�lC)T�IL'1.:5 C' � s <br /> r Name Generating Location <br /> Address 450 E. GRANTL ROAD Address Std <br /> TRACY, CA 95376 SAME <br /> 2 Q 9 —' 8 3 5 9 1 3 3 2 0 9 — $ 3 5 9 ] ?T3 <br /> Phone No. Phone No. <br />',BFI Waste Code © O I Q ctZ Z c'! 3 3 V Containers Type <br /> Description of Waste Quantity Units No. Type D Drum <br /> j C -Carton <br /> I: $ � Fil <br /> B'- Bag <br /> T -Truck <br /> ,i Elm ElP Pounds ' <br /> i. Y -Yards F <br /> Elm ❑ O Other - <br /> 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 tr sport��ation according to applicable regulations. ' <br /> Bas FP,S, PIANT NANAGM f O Z { <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTEFt., <br /> Truck No. Phone No. <br /> Transporter Name privet Name (Print) _e},r - <br />(Address ' <br /> �)��&_VG_01V ehlcle License No.IState t <br /> CC, Vehicle Certification I <br /> hereby certify that the abov named material was picked up I hereby certify that the above named material was delivered with- <br /> at generator site {iste ve. out incident to the desti on listed below. <br /> E <br /> wdli <br /> L� O / <br /> vat re Shipment Date ri r lure Delivery <br /> ale <br /> DESTINATION, <br /> Site Name Phone No. I�J� <br /> F <br /> Address <br /> t <br /> I hereby-cer(ify that the above named material has been accepted and to the best o nowledge the foregoing is true and accurate. <br /> r i <br /> Nam! \uthorized Agent Signature Receipt Data <br /> • . <br /> PASS CODE <br /> 10186 BF1260-720 <br />+ UNLOADING AREA-COPY :'. <br />