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r Waste <br /> 3 No. <br /> 916010 <br /> Systems TM N N- } <br /> BROWNING-FERRIS INDUSTRIES O . HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name !:�:i' ti': i.'1;7.)I1�j::'.�';� r1 r.,L I t "• r, <br /> Generating Location <br /> Address 450 E. GRkqMINE ROAD <br /> Address <br /> i <br /> TRACY CA 95376 <br /> .phone No.;; ..•2. ..' 9 'k $ 9.. 3:. 3 Phone No. <br /> g , <br /> BFI Waste Code 0 I O I Containers Type <br /> Description of Waste Quantity Units No. T pe D- Drum <br /> F O . C-Carton <br /> B - Bag <br /> T -Truck <br /> ❑ ❑ P -Pounds <br /> Y-Yards <br /> ❑ m ❑ 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 nsportation.according to applicable regulations. <br /> BCB FAIGUNEES PLANT M Q i10 Z j 6 Z I <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTEFr.--- <br /> Truck No. r ~ Phone No. n <br /> Transporter Name� �fi_ r.e /r _ Driver Name (Print) ` <br /> �icl C S <br /> i � or� <br /> Address X �- Vehicle License No./State 7t t"7 <br /> � <br /> Vehicle Certification <br /> hereby certify that the above named material was picked up I her y rtify that the above named material was delivered with- <br /> at the enerator site listed bove. out i cide t to the destination li ted belo <br /> 16 12F <br /> r <br /> Driver Signature Shipment Date DrkeYSignifure Delivery Date <br /> DESTINATIONt. <br /> x <br /> Site Name Phone No. <br /> t <br /> Address <br /> .I hereby certify that the above named material has-been accepted and to the best of wledge the foregoing is true and accurate. <br /> i4- <br /> !!atAl Authorized Agent <br /> Signature Receipt D I <br /> PASS CODE j <br /> 10186 <br /> ... • � SFI260-720 <br /> I <br /> UNLdADING AREA COPY <br />