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�s <br /> No.40171b <br /> waste <br /> + TM S SPECIAL WASTE MANIFEST <br /> stems NON-�AZAi�DOU � x lo�4� <br /> t Frit . ;1 _ tscvs .-a- <br /> pnOWNING!-EfiRIS 1StDUSTR1t3S o r ;. .. <br /> � "Y v �ei„ry�1;r}�r't.�w• v�ei — t.,(ll.Y\t. SIiSCioll <br /> t:;:t1C11i, }trtrl-` tire¢ Generating Location <br /> Generator Name Address GO1 £. Kettlurian l.nnc <br /> ftox ;.R11 Lodi. CA <br /> Address ` C,- 91402 <br /> San r�teo• <br /> 2 3 G Phone No- Type <br /> 2 ' Containers <br /> L <br /> t __ l D-Orum <br /> Phone No. 1 Units No. T ° C.Carton <br /> I1 a [� ff Li=— Guantit�BFl Waste Code `� )tion of Waste G o G 1 8 l crl G T B•aag <br /> i— T-Truck <br /> .omp-Pounds <br /> tan ltazardv{ts nudergroupd u Y-Yards <br /> 9011 r' El <br /> etiravat toss 1f p.ether <br /> starnge tack F1 <br /> AO G1:R Part 260.10 or any applicable <br /> described, <br /> a0 CFR Part 261 or any applicable state law, has been properly <br /> i hereby certify that the above named material does not contain free Liquid as defineby <br /> ble regulations. <br /> stale law,is not a hazardous waste as defined by <br /> is in proper condition for transportation according <br /> to app <br /> acka eI and <br /> classilied and p g < <br /> - i J Shipment pale, <br /> (,enetalo,r Authorized oae.I Name .0 <br /> v <br /> 415-634-6850 <br /> '%hone <br /> Truck No. Q r�✓ <br /> Dillard Trul-king- Inc. Driver Name(!Tint} <br /> Transporter Name Vehicle License No.lState <br /> 218 ” <br /> P.a. BOX <br /> AddressGalilortlia 945`1`! Vehicle Certification <br /> � Byron. �` <br /> I hereby certify that the above named material was delivered with <br /> picked up ident to the des ination listed below, <br /> certify that the/above named malarial was P out in�c ,} C- <br /> thereby : G l / / f�. (� / f 1 <br /> at the generator site above, O Ct fk' J !, y� Delivery pate <br /> ! <br /> �priverSignalure <br /> Shipment Date <br /> IT 11 <br /> Driver Signature y p <br /> ' U 1 9 1 <br /> Phone No <br /> P F i. VnsCa Rr.tnd Lanrli!1 l Clz 91550 <br /> site NameLivermore. <br /> •1001 tiot'ttt Vasco Fd.. <br /> Address knowledge the foregoing is true and accurate. <br /> ' certify that the above named material has been accepted and to the best of my/ � <br /> r, f <br /> I y f <br /> Si nature <br /> A..„a of Authorized A enl <br /> PASS coDE BF1260.720 <br /> 10186 TRAWSPOMLl;REFA N <br />