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eWaste <br /> TM • "°� 671788 <br /> Systems <br /> BROYYNINGFERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> 'hevron Pipe Line CowpaD' Alden Park <br /> Generator Name Generating Location <br /> Address 2360 Aucluumn Rd. Address <br /> �Pii t t. ii;ur2. Ca. 94j,,� Tracy, Ca. <br /> Phone No. =D 6 g 0 3 t b o, Phone No. C�]— <br /> BFI Waste Code A I( Containers Type <br /> Descri tion of Waste Duan Units No. T e D-Drum <br /> 0 , 6 + C-Carton <br /> Bunker "C" Contacted Sv i 1 B -Bag <br /> Chevron Service Contract z ❑ m ❑ T -Truck <br /> P -Pounds <br /> Y-Yards <br /> mO-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 ccn5 trarwportation according to applicable regulations. <br /> Generator Authorized Agent Name SiINNEEMgnature Shipment Date <br /> TRANSPORTER <br /> Truck No. f `6� Phone No. (510) 634-6850 <br /> i,i ! lard Trucking �d6f3 <br /> Transporter Name Driver Name (Print)LQM 1 V S I, ) M,., yi <br /> Address P.0 flux 213 <br /> Vehicle License No./State 9C,1-19s CAA <br /> Bron. Ca. 94514 <br /> Vehicle Certification 401514 <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 /> AAM <br /> Driver Sign ure : .0 t Date Dnver SI nature <br /> �H`fT'`r e El <br /> Delivery Date <br /> Site Name Phone No. — <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 AUMorized Agent Sgnature Repipt Date <br /> PAN CODE <br /> 10M <br /> BFI260-720 <br /> GENERATOR RETAIN <br />