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r� <br /> a' ..�.3a- .a as- <br /> .r .;�•+r. > s: ' .ir. - •' ' <br /> �3 <br /> x r <br /> t <br /> _x <br /> No.4Vs11b <br /> f .1 Waste <br /> Systems im <br /> NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> nn0Wr1l1JG-FEF1n1S 0101J�;TMEs r a Y 1 bW r ; • t S 41�v 1 <br /> k1<7 ra.�NT 2t=3"s�i St;lti011 86015 <br /> UI c{moi, ll,r[i r t itu3 Generating Location ----- <br /> Generator Namo— <br /> 601 E. [tckticlntin [.etre J_--- <br /> Address�-.---- <br /> Address Lrxil, - <br /> 4 J Salt lIciteu, ca. 94402 <br /> 1 1 -(7 17]7 J. 3 6 0 Phone No. 1.�..- <br /> Phone No. L".�1 L J __ -7 Containers TYPO <br /> j ����TI I 0-� -� D.Drnrn <br /> 1._..-�•� �� _� L_J Quantity _ Units No, C-Garton <br /> BFI Waste Codc Uuscri lion al Waste ], it 1'- '� TL�1 <br /> T-Truck ! <br /> j l ol, !i t�ardou ::oil JI <br /> >> c P-Pounds .I <br /> C'XCOVFrt:lCtl1 U: uIld > 3 CUtil1C1 Y-Yards <br /> 5t Ur41�C L'allr; <br /> O-Olh°r <br /> applicable <br /> -- <br /> An t co Part 261 or any applicable state law, has been propedy described, <br /> I hereby certify that the above named material does net contain <br /> ,roe liquid as dofinod by A0 CFl3 Pari 260.1 or an <br /> state law, is not a hazardous waste as delined by g applicable regulations. <br /> classi[ied and packagod,and tin proper condition[or Ira sp rt , accordin to app 1 <br /> 51tlpmenlDalo <br /> Genolator AVL 01 A eht Name - r <br /> 415-634-6BJ0 . <br /> T `1 Phone No: <br /> Truck No. ' <br /> Dillard '1'CU'Ckittig,. IrIc Driver Name(Print) <br /> Transporter Nar.o <br /> Address P.O. i:aa 2.ltJ <br /> Vehicle License No./Slate <br /> Li ron, L:alii':arnia 94544 Vehicle Ceniiicalion <br /> I hereby certify that the above named material was picked up oust incidenttothedestinationRina le ion lve it ed below. <br /> amed material was delivered with <br /> al the generator site listed above. <br /> t cir f �� <br /> �J D01I onto <br /> SItipment Dale Drivor Signature <br /> Driver Signature <br /> KOM <br /> 1 .Y1 0 9 <br /> I Site Name <br /> C .E.I. Vasco 1.0ad L.311-Ii.11 Phone No. 4 h 7 <br /> 1 1JU01 i;nrtl) Vacco .Td., bivezrt)re, Ca. 94550 <br /> - - -- -- - - --j--Address - <br /> I I fiereby certify that the above narned material has been accepted and to the of my knowledge the foregoing is true an accurate <br /> ` necelp;Dare <br /> na nl Aullsorizod A onl <br /> i PASS CODE <br /> - BF1256-12r <br /> 10786 <br /> i <br /> Tnn^JSE~Qf1 'En nETA{N <br />