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oSystems TM <br /> vvaste Na. 916020- <br /> � <br /> i. BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST ; <br /> GENERATOR <br /> Generator Name KJ-' <br /> Generating Location <br /> r <br /> Address 450 E. GRANI'iZNE RDADSAM <br /> Address <br />} .... . .TRACY CA 95376 <br /> • SAME <br /> Phone.No, 2 fl . 9 ---- 8 1 3 1 J-9 9 1 .3 3. 2 fl 9 <br /> Phone No. g 3 <br /> BFI Waste CodeD S I d <br /> Description of Waste i 3 d � Containers -Type <br /> ' <br /> C}uantity units No. Type FD <br /> 5��� �•��l. cltQ�� .: ! k � O f � C-Carton <br /> i B - Bag <br /> m T -Truck <br /> P -Pounds <br /> Y - Yards <br /> ❑ m ❑ O-Other <br /> I hereby certify that the abovel named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable k <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 condi ' n for nsportation according to applicable regulations. <br /> i <br /> BOB FAGS, PZANT M <br /> MO <br /> c3 G(l� i <br /> I U Z 6 9 I <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER,' <br /> Truck No, Phone No. n ! <br /> . Transporter Name .,4YA%;:t' �✓( f ' <br /> Driver Name (Print) <br /> Address ��� NB C,� <br /> Vehicle License No./State 37r � 4_A_,,C64 <br /> , <br /> Vehicle Certification <br /> I here ertify that the above named material was picked up I here rtify that the above named material was delivered with- <br /> at th ge erator site listed out i id nt to the des ' tion listed slow. <br /> Driver Signature Shipment Date Driver Signature O <br /> Delivery Date <br /> DESTINATIOU <br /> Site Name Phone No. �— <br /> Address <br /> 1 hereby certify that the above.named material has been accepted and to the bestof owledge.the foregoing is true and accurate. <br /> ,Nary,- Authorized Agent -.Si nature Receipt Q <br />, <br /> J <br /> . PASS CODE <br /> 10!86 <br /> 8F1260-720 <br />_ : UNLOADING-AREA..COPY .. , <br />