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IJ <br /> Waste No 1124029 <br /> Systems rw <br /> FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> B !NG <br /> A r <br /> Generator Name _..SMTTT_1= CPORATIbhT Generating Location <br /> r -S YY <br /> Address _ 19033 W. VATZ,.YHSFY. DI� 'r Address tR� rte' �>n - — <br /> TM4T, WASHU4= 9$032- MACY, CA. <br /> Phone No 2 0 6 — 2 5 1 9 1 - 5 � 5 phone No 9 7 6 — 3 7 2 '4 7 0 :0] <br /> ------------------ <br /> BFI Waste Code 4 0 5 1 -11--] 0 5 -9 6 1 0 0 131= -_ Containers Type <br /> Desert tion of Waste- Quantit --,Units, "No T Q 0 -Orem <br /> C Carlon <br /> 50IZ, -, �.^T j ^ 'y ' (1 7 T l3 -Bag <br /> _ T -,Truck i <br /> P - Pounds <br /> Y - Yards <br /> El ❑ O Other <br /> I hereby certify that the above named material does not con*ain free liquid as defined by 40 CFA Pati 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 to prop er.condition?or transportation according to applicable regulations <br /> `E t �x--1 A �1` i/ Y.Z�C�'-!ti• -r b�- _ T14�M':��fl� � T�-t i�i � , <br /> for Authorized Agent Name7gtitre ' - _ —-;Shipment Date-., <br /> • <br /> .S^tea �] <br /> Truck No f - Phone No <br /> Transporter.Name Driver Narne (Print) r J AJ <br /> 2c lvkw�AddrAss r� L' _. Vehicle License NoJSta]e <br /> Vehicle Certification <br /> i hereby certify that the above name)d-matenal was picked up i hereby certify that the above named maternal was delivered with- <br /> at the gene or site listed above _ ' - out incident the stination list•,d below ' <br /> Inver y P� shipment Date Dnver Signature Deirvery Date <br /> Site Name Phone No �— <br /> Address _ r <br /> hereby certify that the above named material hasrbepn accepted and to the best of my knowledge the foregoing is true and accurate <br /> 1 - ? <br /> Named Atxirortzed Aaeni Snonature - - - - A"iM Date <br /> " - PASS CODE <br /> aF12M7 o 3ts3 <br />