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waste; No.. 91 6'b2_7 <br /> Systems, TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name 'x ' 't�f= �` - ' t' Generating Location <br /> _ Address 450 E. Gr*ANII� R010 Address SAME <br /> CA 95376 SAME, <br /> Phone No. 2 0 9 $ 3 5 9 1 3 1 3 Phone Na. $ 3 5 9 1 3 3 <br /> BFI Waste Code © D s- I 11 d t 12 2 ` . 3 4 3 _� 07 1 Containers Type <br /> Description of Waste _ Cuantit Units No. Tye D - Drum <br /> C-Carton <br /> B - Bag <br /> T -Truck <br /> ❑ m <br /> P - Pounds ) <br /> Y -Yards <br /> Elm 1:1O-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 <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 con • • n for tr sportation according to applicable regulations. <br /> �� <br /> Btu FAGEJNflM, Pyr MANAGER � ��, o 1 z.. 16 Y Z <br /> Generator Authorized Agent Name Signature Shipment Date <br /> Truck No: 3 _ Phone No.L_,%_ <br /> Transporter Name Driver Name(Print)•, <br /> Addresses Vehicle License No./Slat fi <br /> i <br /> Vehicle Certification <br /> i <br /> hereby certify that t above named material was picked up I hereby certify t e above named material was delivered with- <br /> at the generator a It ed abo oZnc-,' e estin vfi H elow. <br /> Dri Sign ur Shipment Data DDelivery Date <br /> OV6 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 my knowledge the foregoing is true and accurate. <br /> Nf- 1 Authorized Agent SI nature Receipt Date <br /> PASS CODE <br /> 10186 SF1260-720 <br /> :.; ..::.l�NL0ADING.AREA COPY :. <br />