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jq' '� , <br /> 0 7 6 6 <br /> rry astei,, *:'r ; �" "iF •. ;a 1 v�,;'' +_�?_c <br /> stems r <br /> Sy TM N JN-�z�. r, ARDOUS,_ t?,ECIA�I t ,S. E MPS A <br /> ROS 11GERRIS INDUSTRIES 4„ F!ir <br /> GENERATOR <br /> M. <br /> f �S `e�..•, - v . u�� r*, '�Ir.,,a'.Y s yyr i 4r'---�i Y ' <br /> t c Name D PRQIDk<CIS Generating Location ARCO�STI TI0M #2093 <br /> �dd i D. Br 1 111 Address 31425 Trac ' )E31vd. _ { <br /> 4� <br /> CA 9-44G2 racy, CA <br /> 4�r� ✓ <br /> � '� k _- ` my e 'x <br /> thon, t 4 TI-11.1 ;r -r •Phone No, Asx t�C* a' <br /> ,. - Containers -,,Type <br /> Code EC �+ t 5 Af s� g 3t.gf O e 2n ,p 7 �4 x� , ,x D -Drum <br /> Description of Waste QuantityUnits No T e <br /> C-Carlon <br /> �ti HA2 ���S 5DI t 0 0 0 1 8 0 B - Bag <br /> I T <br /> T -Trud <br /> -.r .,,, m ❑ P -Pounds <br /> Y -Yards <br /> I ❑ m L j O-Other <br /> .Dy certify in-, the above named material doss not contain tree liquid as defined by 40 CFR Part 26010 or any applicable <br /> law, is not a hazardous waste as defined by 40 CFR Part 269 or anya(iplicable stateRlatkjbas,,beeO properly described, <br /> ' ied and pacF aged, and is in proper condition'far transportation according to applicableregutahons <br /> rfarfzed Agent r..me Slgn ure r,t, 3, Y r Shipment Dat <br /> - <br /> TRANSPORTER <br /> t <br /> Ir <br /> 'ruc' ,s lone No. 3 f(S f 0) ,P34-6 850 <br /> Llard Trucking, Inc. 10Q4/22 r7r- <br /> Trar or Name Driver Name (Print) <br /> fr <br /> Lid, 1�.L' '`. " t 2�$ s�' ` } hicie Licrenpe No/State 14 40 t90 <br /> i `. 5'+N�', I;_ s 3r�z s <br /> kyr` 'A 94514chicle Certi catiArt <br /> e ertlfy that thL above name material was picked up ,Hereby ceiklfy tl at the a�oVe amed material was delivered with- <br /> ' <br /> ti eratersite I1Jre a ove fes; txout incidenjoth estinatioh luted b owi 416 ` <br /> 11 <br /> pave ure SlhlpmentDate ,0, er rgnatttt9,'` RFs Y Sa t elrvery�Date <br /> hL DESTINATION <br /> I- t �w a-.4.. . <br /> ri <br /> Ite B.F Basco Rd. Lar df ill P.O.#02--10054` PhQ7ne No g 4r #� r� 4 ;r 7 w 4 9 1 <br /> .r <br /> 40C '.-th Vds Rood, LivermoFe, CA X4550 <br /> Iddi <br /> Ae <br /> e, .rtlfy that th above named material has been hccepted and to the best of m k wiedgethe foregoing is true and accurate <br /> m �onzed A ent <br /> Signature Huai t Date <br /> Who <br /> PASS CODE <br /> Bf1260 720 3 <br /> r. <br />