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Waste • No. 671792 <br /> Systems TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Ohevron Pipe Line +'o p«r,,'. Alder, P,- <br /> Generator Name Generating Location <br /> Address 2360 Ruehanan Rd. <br /> Address <br /> ��PiLL,iiuF 91 05 Tracv. Ca. <br /> Phone No. Q-1, i� 0 I b i; Phone Np, r77 <br /> BFI Waste Code ® Containers Type <br /> Description of Waste Quantitv Units No. T e D- Drum <br /> nZ7 �r� � C-Carton <br /> Bunter 'un[acted Soil 4 © I � B- Bag <br /> ,_'hevron :iervIce C'ont'act fi T -Truck <br /> mP - Pounds <br /> Y-Yarda <br /> m 1:1O-Other <br /> 1 hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260.tft or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has beelt property described, <br /> classified and packaged, and is in proper conditi or transportation according to applicable regulations. <br /> Denerator Authorized Agent Name Signature ShiDnteM DW <br /> TRANSPORTER <br /> Truck No. Phone No. (g 10) 634-6550 <br /> Hillard Trucking <br /> Transporter Name— G,/l Driver Name(Print) Uo.+c �A Lt ) <br /> Address P-0 Box 21S <br /> Vehicle License No./State 9('1 -Ills- <br /> Q4 S 14 lls- <br /> Q4S14 <br /> Vehicle Certification _LfDI'z It1 <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 /> io <br /> 71 <br /> •. I <br /> Driver 84 fature iShipment Date Driver Signature <br /> Delivery Date <br /> DESTINATION <br /> Site Name Phone No. =— 1 <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 Apert Sltutaturs Recap DatI Ela <br /> PASS CODE <br /> i Wile <br /> BF1260-720 <br />