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by I <br /> Waste, No. 915931 <br /> Systems TM N <br /> BROW*rtNG-FERRIS INDUSTRIES ON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> r <br /> GENERATOR <br /> Generator Name Generating Location <br /> Address 450 E. GRANTI ROAD Address SAME <br /> TiiCX, CA 95376 SAFH <br /> Phone No. 2 0 9 — 8 3 5 9'71 2 3 3 Phone No. =--�–j $ 3 5 9 Z <br /> BF] Waste Code 0 7– 1 Containers Type <br /> Description of Waste Quantit Units No. T pe D- Drum <br /> C -Carton <br /> Shc1 e{ l T B - Bag <br /> T -Truck <br /> F-1m El P - Pounds <br /> Y,- Yards <br /> Elm 1-1 <br /> O-Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 4d 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 tra portation according to applicable regulations. <br /> &BFAGUNE S, PIANT 14ANAGER U)IJ <br /> Ger`, 'i Authorized Agent Name Signature Shipment Date <br /> • <br /> Phone No. <br /> Truck No. - � t <br /> Transporter Name 2 JXADriver Name (Print) <br /> Address , <br /> Vehicle License No.lState- <br /> Vehicle Certification <br /> I hereby certify that the above named material was delivered with- <br /> 1 hereby certify that the above named material was picked up li tarda ave. out in idem to the destination listed below. <br /> at the generator site <br /> Driver Sj atura Shipment Date Driver nat re QeliveUfa <br /> R • <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 /> Name oI Authorized Agent Si mature- eceiot Date <br /> • � ilk <br /> PASS CODE <br /> BF1260.720 <br /> 10186 . <br /> UNLOADING AREA COPY <br />