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NON-HAZAR�USiSRECIAL WASTE & <br /> BESTOS MANIFEST <br /> If waste Is asbestos waste,complete Sections L 11,IIT and IV N O■512 2 6 L <br /> ^ <br /> If waste is NQJ asbestos waste,complete only Sections L TI and III_ 1�1 <br /> aY <br /> Generator Name i11bOt3 Pl::ODt3CT8 C1394M b Generating Location ARCO MTION !06020 <br /> c Address IES 5077 d Address 1711 E. VIOMITE <br /> rPAM. Ch 94622-5077 CA <br /> e Phone No 1925) 299-88.91 p:kuL BLifr}LE f Phone No H/A <br /> owner of the generating facility differs from the generator,provide <br /> Owner's Name AAM PRODUCTS OtWht4y h Owner's Phone No S41111" at& I(e) <br /> BFI WASTE CODE {.` 11 Q S O S 12 $ g L01 fl 5 0TYPE <br /> Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> Description of Waste VAM LkZARD= SOIL B -SAG <br /> k n�s <br /> Units No TYPE BA -6 MIL PLASTIC BAG <br /> or WRAP <br /> Y t7 1 T -TRUCK <br /> O -OTHER <br /> GENERATOR'S CERTIFICATION I hereby Derbfy that the above named material is not a hazardous waste as defined by 40 CFR 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,fl the waste Is a treatment residue of a prevlouoly 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 <br /> hazardous waste as defined by 40 CFA Part 261 9 M' -CUBIC METERS <br /> a� tjw request of APMP Y3 -CUBIC YARDS <br /> PATRICTA <br /> 0 O -OTHER <br /> Generator Authorised Agent Name Signature <br /> Shipment Date <br /> n, a r.«f <br /> � �`TRANSPORTER` d"era or aoompleLe a-d, Trans rter u cgrrt ee�te tfa1 r " <br /> 3 fi <br /> TRANSPORTER I TRANSPORTER H <br /> Of <br /> ame ..JNA-�r—_a 3 <br /> �-�•- h Name <br /> b Address, � r 1U} i Address <br /> Driver N S ).� �� _„4, j Driver Name/TiVe <br /> ~ PRlNT/" wr <br /> Phone No c e Truck No .. PPJNT"E <br /> k Phone No r Truck No <br /> Vehicle License No./State m Vehicle License No/State ` <br /> Acknowledgement of ReCerpt of Matenals Acknowledgement of f teoeipt of Materials <br /> VD,Yer"�- n <br /> Data Driver s nmim <br /> snI tete <br /> site Name BI a* VA= >� SWITMIM LANI1l = 1925) 447-0491 <br /> c Phone No <br /> b Physical Address X41 M. VLSCO RGl�1D 40Q2 of, �Ab�GO �� <br />' d Mailing Address <br /> �r CA 9455L3 I.IVEFJ0 $, CA 94550 <br /> a Discrepancy Indication Space <br /> hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> J4Bf 1007/107 <br /> of Anent signan,re POO 09-31398 <br /> Receipt Dam <br /> t 7 I Tr <br /> ppers`s*Name <br /> b Shippers's*Phone No <br /> hipperVs*Address <br /> I $Nppers%Special Handling Instructions and additional Information <br /> WTTFICATION I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packaged <br /> ed.and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations <br />