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Waste . J No. 71 '; 04 ,; <br /> Systems M NON-HAZARDOUS. SPECIAL L WASTE MANIFEST <br /> 1 BROWNING fEF3RlS tNDUSTRI S <br /> GENERATOR <br /> Generator Name Generating Location <br /> Address P. 0. PDX 5135 Address 437 'r_. *finer ave. <br /> iSan Ramon, C... S3 SLock Lc„> C.A <br /> i <br /> Phone No. I —I 17 3 6 8 Phone No. <br /> C a 1. ) <br /> BFI Waste Code m LJ��L7 r 11 <br /> J O Containers Type <br /> Description of Waste Quantity Units No. Type D-Drum <br /> El El C-Carton <br /> � B-Bag <br /> Non Hazardous Soil m El T -Truck <br /> P -Pounds <br /> Y-Yards <br /> E m ElO-Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable <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.q <br /> Generator Authorized Agent Name Signature , Shipment Date <br /> 1 TRANSPORTER <br /> 4-6850 <br /> Truck No. <br /> , Inc. 143/93 »���4 � 3 ' V. �r N <br /> Transporter Name Dillard TruckingDriver Name(Print) I / <br /> Address F• o. Box 218 Vehicleticense No./State <br /> Bvron, California 94544 <br /> Vehicle Certification <br /> 1 hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the generator site listed above. out incident to the destination listed below. <br /> Driver Signature 1 Shipment Date Driver Signature / Delivery Date <br /> �r <br /> DESTINATION <br /> Site Name B.F.I. Vasco Road Landfill Phone No. 5 1 0 4 1 4 1 i 1 0 4 9 'I <br /> 4001 North Vasco Rd. , Livermore, Ca. 94550 <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best a4v kno, dge the egoing is true and accurate. <br /> Name of Authorized Agent Signature Remit Date <br /> PASS CODE <br /> BF1260 <br /> 10166 -, <br />