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j ■■aaae : : 5 No. 916022 <br /> Systems TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name iY''`'.:L: '`'�`'f'`' U}r} ' Generating Location <br />! Address 450 E. GRANTIM E ROAD Address SP�?E <br /> TRACY, (M 95376 SAME <br /> Phone No, $ 3 5 9 1 3 3 Phone No. 2 0 9 <br /> BFI Waste Code G b s C7 1 HKEZ 3 `� 3 b Containers Type <br /> i Description of Waste QuantitV F-1 I _ Units No. T pe 0- Drum <br />� L C-Carton <br /> 50; 1 �r c�_'osQ! i I [I b B - Bag <br /> T -Truck <br /> ❑ m ❑ P - Pounds <br /> Y-Yards <br /> f ❑ m ❑ Q-Other f <br /> 1 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 condit' for trapportation according to applicable regulations. <br /> BCB FAGUND:S, PIAL!' NSR M9.5 <br /> L(.Aj 6�u O 2_ 6 <br /> Generator Authorized Agent Name Signature Shipment Date i <br /> TRANSPORTER'..... <br /> 1 <br /> Truck No. _ Phone No. <br /> TransporterName Z ' Driver Name int) .�O �✓� <br /> E: Address__ f1 1 r�� �� ��• � �j Vehicle License No./State <br /> Vehicle Certification - " 17j!0 <br /> hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> at theg "rat r i listed above. out incident to the d�esti tion listed below. <br /> Driv ignature Shipment Date Driv Signature Delivery Date <br /> DESTINATION, <br /> Site Name Phone No. <br /> Address <br /> .I hereby certify that the above named material has been accepted-and to the best of m kn ledge the foregoing is trueand accurate. <br /> .7 <br /> Na -Authorized Agent "Signature _-w,Date— <br /> PASS CODE i <br /> 10186 BFIM-72o <br />' UNLOADING:AREA' CQPY <br /> E l <br />