Laserfiche WebLink
Wastes <br /> TM - 916 012 <br /> Systems <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> G e ator Name :X',om', PRODI:CIS 0a'4?ANjr <br /> Generating Location SA11T., <br /> Address 450 E. GRAN EmE R0AD Address SAME <br /> J},. _ • _ TRACY, CA 95376 - - SAM i <br /> Phone No:`'.ERE] ,- 3 5 IiHT 2 .a7, ..9 _8,, 3_ <br /> Phone No. 9 ' <br /> BFI Waste Code + = 1 b 1 z ( 3 (� Containers Type <br /> Descrlptlon of Waste 1 ` <br /> Quantic Units No. T pe D Drum <br /> C-Carton <br /> ( G a - Bag <br /> T -Truck ' <br /> i m 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 GFR Part 260.14 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 cond' ' for 7ds��� <br /> portation according to applicable regulations. ' <br /> BM FAGUNDE',S, PLANT i��R J [N D Z G `( <br /> Generator Auth-riza•Agent Name Signature <br /> Shipment Date <br /> TRANSPORTER, <br /> f <br /> Truck No. Phone No. <br /> Transporter Name if%7 Driver Name (Print) <br /> Address <br /> Vehicle License No./State <br /> 64 <br /> Vehicle Certification 0 <br /> I hereby certify. the ovqlnamed material was picked up I hereby certify that the apove named material was delivered with- <br /> at the gener D i e li ed v out in e t to the des ' tion listed below. <br /> 9 2 ! 2 <br /> Driver Sign re Shipment Date Dri nature Delivery Date <br /> DESTINATIOM <br /> Site Name Phone No. �— <br /> i <br /> Address r <br /> I hereby.certify that the above-named material has been accepted and to the best-of my knowledge the foregoing is true and accurate. <br /> Name Nuthonzed A ent <br /> Si nature 'i Receipt Date } <br /> PASS CODE <br /> l Oltifi <br /> • r SFI260.720 <br /> h UNLOADING"AREA' CQPY <br /> J <br />