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` - tr lrs " ���r t,`;='�:-..`x'�t'+F^sY"P'' 3 A tido y s +f.;-^�fl r �a� •r��'� � _ J h•+ <br /> � <br /> ,M• ' ' <y t �" :fw'J`t ^.�='.3#r��? ' l i ? r T h a =i iql 4 �NU�� 'i 77 447 <br /> .xr i�, -�� - .. � tP. S �.�^ a 3 • ;��aSrrs; ,.. ' y:r.3''h�-y '� > i <br /> VMS'�' <br /> e � <br /> BR��H�= RRis iNDUSTMEs �� , 1 =HAZAF3 ] l �S SPECIAL---WASTE,- I 1 1V, F' <br /> Generator Nartte-°A 1d 'PRUDUCTSr ,�•-- <br /> t Generaitng Location ARCA STATION #2119.3_ , <br /> Address P.O.-Bax 'SBi l Address 3425 Tracy Blvd. <br /> San Mateo, CAs 94402 ' Tracy, CA <br /> 'Phone No 4 1 S — Phone No <br /> BFI Waste Code C A 4 0 5 O 9 © 2 9 3 6 0 2 0 7 Containers Type <br /> Description of Waste - _ �r Quantity -Units'r, No Type D-Drum <br /> C-Carton <br /> NON HAZARDOUS SOIL 0 1 0 0 1 1 8 '® B -Bag <br /> ❑ 1�J ❑ T -Truck <br /> P -Pottnds <br /> . . t ' Y-Yards <br /> Elm El 0 <br /> -Other <br /> 0 r - <br /> hereby eerttf� 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 tsyin proper condition for transportation according to applicable regulations <br /> �AuthoriFed Aget>L r; f '-T -r -. Signgture . r Shipment Date ':: ,` <br /> t <br /> TRANSPORTER <br /> X .e <br /> ruck No, __Prond No " <br /> (510) 6x.14--6850,- <br /> .. — r., d +r,: �it+1s�,� „•k, r4i` .,y,..r � <br /> S , cicfit ^ # '. laf421NI3ard-Ti-; <br /> Transport9r %" r <br /> _ <br /> Dnver f4ame (Print) <br /> dressf t-} -- Vehicle License No/State <br /> � .� '�> _�� �• O �L <br /> •< •, . , ,k•• .r Vehicle Certification a <br /> hereby certify haat the above earned fnatenal was picked up - 1hereby-certify that the above reamed -material was delivered with- <br /> at the g9aqrator site bsted above out incident to the destination listed below ` <br /> Dnver Signature s Shipmdnt Date Driver Signature DeiWery Date <br /> DESTINATION <br /> Iite Name E.F.I. Vasco Rd. Landfill P.O.#02-10054 phone No 5 1 0 — 4 4 7 1 4 4 9 i <br /> ddress 4001 North Masco Road, Livermore, CA 94550 <br /> 'hereby certify that the shove named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> fm,ofAAuthorized Agent Signature Recei t Erato <br /> ' PASS CODE <br /> BFI260 720 3, <br />