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Waste. Y No. 916 017 <br /> systST TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Genilor Name I=.•;'DIKLS Generating Location <br /> Address 450 E. GRANT.TN' R= Address SAME <br /> TRACY, CA 95376 SAME <br /> Phone No. 2' 0' 9 8- 3 5 9, �. 13 13' <br /> Phone No: 0 9 — 8 3 5 9 1 3 3 ., <br /> BFI Waste Code C A �f O S ( O z 3Iq III-", O Containers Type <br /> Description of Waste Quantitv Units No. T pe D - Drum <br /> C-Carton <br /> T B - Bag <br /> T -Truck <br /> El m ❑ P - Pounds <br /> li Y-Yards r <br /> _ ❑ m ❑ 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 nsportattiion according to applicable regulations. . <br /> BOB FAGU1vDES Q I�AXL� '! ,.I b2- G <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTEFt,,.. <br /> Phone No <br /> Truck No' ' rY <br /> Transporter Name Driver Name (Print. t <br />;Address A Vehicle License No./State f( <br /> Vehicle Certification F <br /> hereby certify hatvthe above named m terial was picked up tDrive)tidirf6t6re <br /> y certify t t above amed material was delivered with <br />.at the gener�' listed e. ent t he stinati ist low. <br /> er Signature -Shipment Date Delivery Date <br /> DESTINATIOU <br /> Site Name Phone No. <br /> 4 <br /> Address <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 /> Nen" 'Authorized Agent S nature � Receipt Oahe <br /> PASS,CODE <br /> 10166 6F1260-720 <br /> Y <br /> UNLOADING AREA COP <br />