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3 <br /> Mm <br /> too. 48GI 3 <br /> WasteSPECIAL WAST 511 <br /> MANIFEST <br /> Systems ,M ON-HAZARDOUSt <br /> p NOUN <br /> ,OWtI1t1G•FEnF11S INc)USTnies {0015 <br /> Ul•11 11 <br /> rel{f-5'r Ste',�t.Yh;y f r(a •d '..f:.t c�'fij J x111, [taL L <br /> -A U <br /> Gem0falin(g(_oCaliOn <br /> rt1n9 t;clL_ l�t:k'Ir lustre __�--- <br /> Grmnralyr Narne-- - Addloss <br /> o:L Loci, CA <br /> U- 9 i_� _•-_ <br /> t • -- <br /> nddrOss _ - <br /> (,LAI <br /> 9'iP. <br /> ------ E3 Phono No. ��1�� -� Type <br /> - 2 3 Containers D-Drum <br /> �1� Na_ TY.00 C.c,uton <br /> Phone No. _ 1l if j� L�� Units 1_ _t t <br /> i l-1 l� ��� �uarlti i_ u Y c) k 1 T-Eing <br /> t)f-I Waslc Code 1 -- Descri�on°�— u-}- T Truck <br /> El r�� p.Pounds <br /> t;vi.{. i Ltw, 1L 1D y.yards <br /> l.Grl oi: unu:c.Lc3�outiaElEll U.plhar <br /> LtGLi]CjC LJtI{: EEff__qu ��e <br /> y applicable <br /> i 41) CF' Part be" or fly described <br /> � uid as donned by has boon pt P y <br /> 4 — 40 CFt I Part 261 or any applicable stale law. <br /> ly applicable regulaliol,s• <br /> t hOleby ce+tity that ih0 above named male[iai days not contain ire© Iq <br /> stale law, is not a hazardous waste as dyfined by / <br /> and packag <br /> ed and is in proper condition for lra�orlation according 3 I <br /> classilied/ //)I elf /� Shlpn,oniP re r,�i <br /> f 1Ig <br /> I <br /> ,1,anzed Agrnl l•ma 9 <br /> Genarntor Au M .r 415-634'S �O <br /> phone No. <br /> '� prml <br /> Truck No. Driver Name <br /> 11111i1L� r1Luc.dfAr Inc.1t1C 1 <br /> Transporter Name Vel,icie License No./state rJ <br /> P.O. l'o:: ?1U <br /> Address j<yLUE1r C{iiitosrri.a 94544 Vehic{e Gerlilily t on <br /> thy above named material was dolivered will"{ <br /> hereby cert'tty that <br /> thereby certily that the above named material was p <br /> icked up out incident to the(last <br /> inalian tistedFbelow. - <br /> at thegenerator site listed above. <br /> . • Dalivery Dala <br /> j -~. _- (] r +Driver Signalura <br /> ��.�y1 iJ}U .-•�iri`�"_ .. S1,ipmsnleata t Y <br /> VlI a <br /> r i 1 <br /> °[aver Signawrg 4 9 U <br /> q.1 <br /> •,,h�E •;�si ' '1 _ _Phone No. 1 <br /> Vasco Ra1c1 Lf�tid%ill Ga. 9A550 <br /> Site Name��� Vasco i:d.+;t�icerniOLUr <br /> 4001 t.iorkt) V a the foregoing is true and accurate. <br /> 1 knowledg <br /> } Address <br /> i l hereby <br /> certify that the abov0 named matolial has been accepted and to the Best Of <br /> ��� Rec© l palms` <br /> _............. .----- -.......__...._... ---.......... ... ...gl nature _ _ ....... ..._.... - ...._..._.. _........._ .............. <br /> ,,e dS Aull,odze .724 <br /> d A enl <br /> . PASS COVE aMro <br /> ! <br /> 10106 Tmmf31'OITTCEZ ti tETNt l <br />