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•WasteTM • •., 3: . _ No. ? o <br /> 'System <br /> s <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name ''`"` "`""`"" Generating Location <br /> Address P. C. Box 3155Address 437 E. Miner Ave. <br /> San Ramon, 4a. 9458' SL,,ck Lon, CA <br /> Phone No. ' 1 — 2 b a Phone No. <br /> BF ❑c a s t a 16 <br /> I Waste Code Containers Type <br /> Description of Waste Quantit Units No. Type D-Drum <br /> L—L—I—LL_6=J ❑ C-Carton <br /> El <br /> B-Bag <br /> Non Hazardous Soil ❑� m T -Truck <br /> 1:1 El <br /> P - Pounds <br /> Y-Yards <br /> ❑ ❑ ❑ o-other <br /> j 1 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. <br /> i <br /> Generator Authorized Agent Name Signature - Shipment Date <br /> i <br /> TRANSPORTER <br /> I <br /> / Phone No. 510-634-6850 <br /> Truck No. <br /> Transporter Name Dillard Trucking, Inc. 143/93 Driver Name(Print) <br /> Address P. 0. Box 218 Vehicle License No./State <br /> Byron, California 94544 <br /> Vehicle Certification <br /> I 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 /> Qozf z 1in'7' UZ19qL <br /> Driver Sign tura Shipment Date Driver Signature ' 'r Delivery Data <br /> DESTINATION <br /> I <br /> Site Name B.F.I: Vasco Road Landfill Phone No. 5 1 0 — 4 1 4 1 7 1 0 1 4 1 9 1 1 <br /> I 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 of my knowledge the foregoing is true and accurate. <br /> Name of Authorized Agent Receipt Date <br /> d /II PASS CODE <br /> ILII low1� BFl2600.72( <br /> VV �d6 ;I <br />