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R, 9NOPME <br /> 1 <br /> Waste <br /> ' .S TM ppUS SPECIAL WASTE MANIFEST <br /> systems NDN-NAZAR <br /> DUOWtlll1U rERItl5 ItJpUSTTlIGSRIM" <br /> t <br /> .rT, <br /> F� w � t'•� �tl �I � , <br /> � ti rx .ra �4+ .>e� •:+ e .,a- — _ribtU•� .-f�,�,�t��•�,�y..:?- ' •. , r, 9tut,tun <br /> Generating Location —""-� <br /> Generator Name_ UUI L. t" t.t.i�m::rt 1';lne �f�--•— <br /> Address 1----`.�---- - <br /> Address .—.- ---—. —.-- <br /> ---�— [,udi. CA _ <br /> rJ-t�tU2 �. 1�.��.�------�--.�.._- _ <br /> 2 , ; 2 3 G 0 Phone No _ <br /> { Containers TYPp <br /> Phony No. �!Lr�-Drum <br /> - Units _No. 7yPo <br /> Qtlariliiy C-Garton <br /> gr~t Waste Code -L---'' pescri tion of Waste Y —'- U (r r� 1 ft Y� El 171 L� 13_Dag <br /> �[- T -Truck <br /> ;curt Nazarrluus Solt from t ❑ P'Pounds <br /> exl;avatiotr of tllltit'C`Iil'11113rCi LL�� t-- y_Yards ! <br /> sturaye Lan1 <br /> �j O.Otiter <br /> J <br /> (cable � <br /> b 40 CFR Part 261 or any applicable state lour, has been properly <br /> described, i <br /> s. <br /> tereb certify that the above named material does not contain free liquid as delineri by 40 l uta as boort p or 'trty a <br /> r Y licablo g <br /> state law, is not a hazardous i5 waste <br /> condition for transportation according to app' <br /> classified and packaged, <br /> JJ / <br /> nt NarI i <br /> Generator Aulhvriz5d Agi.- <br /> " .tI5-s3i-etlG0 <br /> Piione No. <br /> Truck No. a' <br /> • Dillard Trucking, Inc. Driver Name(Print} <br /> Trr...aporler Name -- <br /> Vehicle License ND.lSta <br /> P.O. pox 216 <br /> le <br /> Address <br /> Vehicle Certification =may <br /> ",�rorl. California .9�5.i4 , <br /> I hereby certify that the above named material was delivered with- <br /> f hereby out incident?o the destination listed below. <br /> certify that the above named material was picked up /_� ' <br /> at ilia generator site listed abev / j J/t Jam- rG �f /]-, <br /> �y <br /> Z/ ` --f fl.f-` i�/ h— L)elivery Date 1 <br /> I vvr sigpatur i <br /> ShiprmntDate .� - <br /> Driver Signature <br /> Iii 't'4 a n ie U 9 t [ <br /> ���Phone IN <br /> B.F.J.FVasco Road t.<lndfill <br /> Site Name <br /> lUOi ?iurtlt Vasco Rd., Livermore. Ca' U•15.,4 � <br /> Address�F knowledgerihe foregoing islrue and accurate- <br /> / [_ <br /> I hereby cr.=!'ty that the above named material has been accepted and to the best of m�� r'�� �� <br /> Receipt Date l <br /> _------__— __.____- -----Signaluref - <br /> Y <br /> t�ar Authariiod A ent _Y <br /> PASS CODE eF1260-720 <br /> 1x106 <br /> TRAftSf'0QTLN 4j><TAIN <br />