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r� NON-HAZAWOUS SPECIAL WAST& ASBESTOS MANIFEST If waste is asbestos waste,complete Sections 1,II;III and IV. If waste is NOT asbestos waste,complete only Sections I,11 and III. NO. 6 °" . �4«�.-bH�n:-ri�.•.. ��:�.._,�� 4��:GENE�ATOR�(Garierato��orimpieies all ot:sect(an,�•��- a..Generator Name: ARCO PRODUCTS 00 b. Generating Locati A C'0 # 06080 d. Address: c. Address: POB 5077 8.5 LOUISE AiVEr-RIE BUENA PARK, CA 3()622-5077 LATHROP, CA 06225-077 e. Phone No.: ! 3 2 5► 2 9 9_e 8 9 f. Phone No.: 5) 21,-99-g g 91 If owner of the generating facility differs from the generator,provide: g. Owner's Name: PAUL SUPPLE h. Owner's Phone No.: TYPE I. BFI WASTE CODE A r t U r `? 1 ,l i ca Containers DM- METAL DRUM DP - PLASTIC DRUM B - BAG j. Description of Waste: r.f i'' t L k Quanti Units No. TYPE BA - 6 MIL.PLASTIC BAG r or WRAP n-f 7-i! t.: !: ' a ,- I : - MMTRUCK i OTHER GENERATOR'S CERTIFICATION: I hereby certify that the above named material is not a hazardous waste as defined by 40 CFR Part 261 or UNITS any applicable state law, has been properly described, classified and packaged, and is in (proper condition for transportation according to P POUNDS applicable regulations;AND,if the waste is a treatment residue of a previously restricted hazardous waste subject to the Land Disposal Y YARDS Restri tion j,16ertify and warra that the waste has been treated in accordance with the requirements of 40 CFR Part 268 and is no longer a M3 CUBIC METERS haz�r oUslwaste as defined by0 FR Part 261. Y3 - CUBIC YARDS O - OTHER / Oe )br�6gent N me Signature Ship ment Date SeCttoft_ ° A7TRANSPORTER, Ge . m� � � rd n� i. TRANSPORTER I TRANSPORTER II a. Name: DIMARD ART') `TRIIC'FfIM—� Tidi h. Name: b. Address: `-a -C,X ST-,'•-; i. Address: c. Driver Name/Title: j. Driver Name/Title: PRINT/TYPE PRINT/TYPE d. Phone No.: i Q?ri 1 6 14--6 q r,t]e• Truck No.: `f 1 k. Phone No.: I. Truck No.: f. Vehicle License No./State: ( 4J`!s(P m.Vehicle License No./State: Acknowledgement of Receipt of Materials. Acknowledgement of Receipt of Materials. g. 4' -�-�,ZN % U C% 7 4 n. river Signature Shipment Date Driver Signature Shipment Date .., S@ctl0n'III' a DESTINATION;(Generator`oompletes a-d,desnation s(te completes a-f.) F1 - �;ASf::n i.9 5 ) 44 t--J4`: 1 ' . a. Site Name: c. Phone No.: b. Physical Address: d. Mailing Address: r.I'd FRMO RE, e. Discrepancy Indication Space: I hereby certify that the above named material has been accepted and to the best.of-my, nowledge the foregoing is true and accurate. 7. ; r Name of Authorized AgentSignature Receipt Date ' •- - Section IV'.- ASBESTOS (Generator complete a-d,f,g,Operatorcompletes e.) a. Operator's'Name: b. Operator's`Phone No.: c. Operator's`Address: d. Special Handling Instructions and additional information: OPERATOR'S CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified,packed, marked,and labeled,and are in all respects in proper condition for transport by highway according to applicable international and government regulations.