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Waste No. r• 15 0 ? f <br /> Systems TM _ "� <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECI'A'L 1N.A MANIFEST <br /> GENERATOR <br /> Generator Name r ' "PL it"` Generating Location <br /> Address EBox 3 15 3 Address 437 E. !:t < .ave. <br /> Son Ramon. Ca. 9583 5[o�k Lon; CA <br /> Phone No. —I ` I ' 1 .. I 3 ° t Phone No. <br /> 1 4 b <br /> m Containers Type <br /> BFI Waste Code <br /> D-Drum <br /> Description of Waste Quantity � Un❑its No. T� C-Carton <br /> B-Bag <br /> Non Hazardous Soil El m El T -Truck <br /> P-Pounds <br /> Y-Yards <br /> FTI El O-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. <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> <� �/ 510-634-6850 <br /> Truck No. Phone No. <br /> Dillard Trucking, Inc. 143193 <br /> Transporter Name Driver Name (Print) <br /> Address P. 0• 'Box 218 Vehicle License No./State � 7`'S <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 listt�d above. out incident to t e'destmation listed below. <br /> FZ <br /> Driver Signature Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> Site Name B.F.I. Vasco Road. Landfill Phone No. 5 1 0 — 4 4 1 7 0 T T9_Fl <br /> w001 North Vasco Rd.. Livermore, Ca. 94550 <br /> Address <br /> i <br /> I hereby certify that the above named material has been accepted and to the best of my knowledge the f ng-tS rue and accurate. <br /> Name of Authorized Agent Signature Recei t Date <br /> PASS CODE <br /> 10186 BFl260-71 <br />