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NON-HAZARDOUS SPECIAL WASTE & _313ESTOS MANIFEST <br /> If waste is asbestos waste,complete Sections I,II,III and IV No. 512253 <br /> If waste is NQI asbestos waste,completezmly Sections 1,I1 and III <br /> _ �� r - � � SEN BRATOR;{Qer eEator oorr# es�l o 5eci ti i' `W I <br /> te <br /> Generator Name <br /> ARM PRODUCT:' COMPANY b Generating Location ARCO STATION 00602(, <br /> a <br /> c Address F06 5'_,77 d Address _ _. 1711 RR Yosn 1IT), <br /> IWMA 1"X4p CA 90622-5077 MANTECA CA <br /> e Phone No (925) 299-689I PAUL StTPF'LF,' f Phone No H/A <br /> f owner of the generating facility differs from the generator, provide - <br /> Owner's Name AROD PPODUCPS CO�WANy h Owner's Phone No Sa=02 as I(e) <br /> TYPE <br /> BFI WASTE CODE C 4 d 5 0 5 1 29 0121 0 5 U Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> B -SAG <br /> Description of Waste NON-HAZAtI:DOUS SOIL k Qu ritity Units No TYPE BA -6 MIL PLASTIC BAG <br /> or <br /> Ho <br /> 011 J] E <br /> � 011 T -TRUCK <br /> O -OTHER WRAP <br /> GENERATOR'S CERTIFICATION I hereby certify that the above named material is not a hazardous waste as defined by 40 GFR Part 261 or UNITS <br /> any applicable state law has been properly described, classified and packaged and is in proper condition for transportation according to P -POUNDS <br /> ' applicable regulations AND,If the waste Is.a treatment residue of a previously restricted hazardous waste subject to the Land Disposal Y -YARDS <br /> Restrictions I certify and warrant that the waste has been treated in accordance with the requirements of 40 CFR Part 268 and is no longer a M3 -CUBIC METERS <br /> hazardous waste as defined by 40 CFR Part 261 atit the rqq—,ioR.t of ARCO PY3 CUBIC YARDS <br /> O -OTHER <br /> + I 'M <br /> — - <br /> Generator Authorized Agent Name Signature Shipment Date <br /> �'F�ANSPQRTERenerompletar <br /> e d �r p' , <br /> TRANSPORTERI TRANSPORTERII <br /> ame ^,)/P', 4, `_" 0 i'1 h Name <br /> b Address C-16" <br /> �� C _ ir ( t Address <br /> c Driver Name/F'rtle ;�L/e'_4/)A 4.J 1 jF CZ 6t I Driver Namefritle <br /> / MNTPWEPRINT/TYPE <br /> Phone No �� 4 �• 3 �7� _ e Truck No c-'-) k Phone No I Truck No <br /> Vehicle License No/State 5 /.L-7 - m Vehicle License NoJState <br /> Ackn Medgerne�ntt offR�eceipt(of�Materials Acknowledgement of Reoeipt of Matenals <br /> ShIM Dates netue S Date <br /> E <br /> r,Srte Name BFI — VAWO MAD SAHITART LAHID�= c Phone No (925) 447•-0491 <br /> Name <br /> b Physical Address 4001 8, VAS+CO �!D 4001 N. VASW ROAD <br /> ys d Mailing Address <br /> LIV2111MOREii, CA 945 0 L1Vlf8 "OlItE, CA 94550 <br /> e Discrepancy Indication Space <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 /> JOB# 1007/107 <br /> f PO$ 09-31398 <br /> Name d putttiprized Apmit signature Receipt Data <br /> ippers's*Name b Shippers's*Phone No <br /> Shippers's*Address <br /> d Shipperst Special Handling Instructions and additional Information <br /> TIFICATION 1 hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, package <br /> ed,and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations <br />