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fo,, Waste ' - v No. 91601$ <br /> Systems <br /> TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name COALS E,01)=S CCtT1_'1L\>r Generating Location 5X,T. <br /> Address 450 E. GRANT= ROAD Address SAME <br /> ff TRACY, CA 95376 SAME <br /> Phone No. 2 Q 9 8 3 5 9 '1 3 3 Phone No: 2 0 9 �'8 3 3= 3 <br /> BF] Waste Code 19 10 5- o I Containers Type <br /> Description of Waste Quantity Units No. Type D-Drum <br /> FYI [ijt [ C -Carton <br /> So;l W c\to�Q� O .;B -'Bag <br /> i T -Truck <br /> :� ❑ m ❑ P - Pounds <br />{ Y -Yards <br /> ❑ m ❑ O-Other - <br /> I hereby certify that the above named material does not contain tree liquid as defined�by 40 CFR Part 260.10 or any applicable I <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 sportation according to applicable regulations. <br /> BOB F?.GUNlES, <br /> PLANT MMMSER f G1� ( p Z 6 w <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTEW- <br /> 7 <br /> 4 Truck No. Phone No. ' <br /> Transporter Name Driver Name (Print) <br /> Address Vehicle License No./State <br /> Vehicle Certification <br /> hereby certify that the above name 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 /> Driver Signature Shipment Date Diver Sign ure Delivery Date <br /> r • <br /> Site Name Phone No. —I - <br /> Address <br /> .1 hereby certify that the above named material has been accepted and to the best of.my knowledge the foregoing,is true and accurate. <br />:.NaAuthorized A em Si nature ' .. .. _.. .. .Receiat Oate <br /> .Ei PASS CODE <br /> 10/86 BF1260.720 <br /> UNLOADINGAREA COPT <br />