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Waste No. 4 01 ! 11 <br /> i <br /> BROWNING-Forlis INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> UNOCAL Marhetiing UNOCAL. Station 96015 <br /> Generator Name Generating Location— <br /> Address P. O. Box 501I Address GOI E. ftettleman Lorre <br /> :rur Miiteo, rn. 9-1402 Lodi. CA <br /> i <br /> i <br /> Phone No. <br /> _.,. —__ Phone No. <br /> BFI Waste Code �. Containers Type <br /> Description of Waste Quantity Units No. T o D:Crftaa <br /> rurn <br /> G n n t AlO <br /> 'toil fhtzal-du:r, Se11 f ronr B-13acd <br /> excavat1 <br /> storage <br /> of underground ❑ � ❑ T-Truck <br /> I s turay;e tank P-Pounds <br /> I <br /> Y-Yards <br /> f ❑ O-Other <br /> I hereby certify that the above named material does not contain tree liquid as defined by 40 CFA Part 2600.10 or any applicable <br /> i <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 transportation according to applicable regulations. <br /> / i , ,`--�'•.�'�_ �l,�r'f:+`'�� ' %orf frj!' - - .1 r ,i <br /> Ge+icrator AuthorizeQ Namo Signature Shipment Dale <br /> ��. .Y,.• �.. �, <br /> 1 <br /> t <br /> 4 Truck No. • Phone No. 415_034 U$50 <br /> I Dillard Trucking, Inc. <br /> Transporter Name Driver.Name(Print) L��� 6&c-4-0 <br /> Address P'O' Tac x 218 ' <br /> _ Vehicle License No.lState_31I yIL.._'z <br /> Dyi,vn. California 9.1;,544 _ <br /> - Vehicle Certification <br /> I hereby certify that the above named material was picked uD .,..I hereby certify that the above named material was delivered with- <br /> at the generator site listed above. out Incl ,ant to the destination listed below. <br /> 13 ..•-'/ .�,._ :f!� -- Lr <br /> Drtyr signature Shipment Date --Driver Signaarre Delivery Date <br /> T-, a <br /> D.P.I. Vasco Road Landfill 4 1 5 - 14 i D ! 9 1 <br /> Site Name Phone No. <br /> x;1041 North Vasco Rd. Livermore, Ca. 9.1550 <br /> Address <br /> 1 hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> iTi r Authorized Agent 1 Si na[ura - Recoipl Date <br /> .. PASS CODE <br /> aF126e-720 <br /> TRANSPORTER RETAIN <br />