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7 <br /> NON-HAZAROk,wUS SPECIAL WASTE & ._SBESTOS MANIFEST <br /> If waste is asbestos waste,complete Sections 1,II,III and IV O <br /> If waste is N_QI asbestos waste,complete only Sections 1,U and III • <br /> x <br /> a Generator Name "�8 � b Generating Location ARM B'1'A'I`IOTf f#W20 <br /> c Address PW 5m d Address 3711 Z. Tomm <br /> =2= PAW, CJI 90622-5077 HANTEMi <br /> e Phone No (M) 289-8891 PAUL MPPLE f Phone No "/A <br /> If owner of the generating facility differs from the generator,provide ' <br /> g Owner's Name ARM PRODUCTS C DWA" h Owner's Phone No Sao* an 1(e) <br /> r BFI WASTE CODE �i 015 1 1 2 9 0 3 �sFo <br /> Containers DM-METAL DRUM UM <br /> DP -PLASTIC DRUM , <br /> J Description B -BAG <br /> on of Waste k Quant units No TYPE BA -6 MIL, PLASTIC BAG <br /> 0LO <br /> D Q N <br /> T TRUCK WAP V O -OTHER <br /> GENERATORS CERTIFICATION I hereby certify that the above named material is not a hazardous waste as defined by 40 CFR Part 261 or UNITS <br /> any applicable stats law, has been property 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 /> Restncbons 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 M' -CUBIC METERS <br /> hazardous waste as defined by 40 CFR Part 261 at f(r� PIRMA TS PANT Y3 -CUBIC YARDS <br /> t,[ffi.IAZA JOWAI DZ?J+ARD RtQi�IRiM, �f 'f `� r O -OTHER <br /> { s <br /> Generator Authorized Agent Name Signa e - Shipment Date <br /> �TRAMSPURTER Gene �orcomptate�a ,�rra °s ire uE�r�' ti n� � '� <br /> TRANSPORTER I TRANSPORTER II <br /> a Name - _ - _ h Name - - -- - - <br /> PM 579 <br /> b Address i Address <br /> S�f>ti IM, CA 94514 <br /> t - <br /> c Driver Name/Title -j-Driver IVame/Title - <br /> 634—"50 PPJNTVWE PRiNTMIRE <br />_d Phone No a -Truck Nq.�- — - - - k-Phone No)YI --- — _—_ -- I -Truck No-- - - <br /> I Vehicle License No./State ?\ m Vehicle License NoJState <br /> Aclmowl a of t of M tett s nn Acknowledgement of Receipt of Materials <br /> ' �r l <br /> Q n <br /> na°"° sir Mata Driver s nature 5rr Date <br /> a. Site Name VA= ROLb SMZTMM J AEiDr LL� � (925) 447-0491 <br /> c Phone No <br /> b Physical Address 4001 W, VASCO RMD - d Malting Address 4fl01 Ds VASM ROIiD <br /> LIVERNOM CA 14550 LrVED 4" , 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 /> JO$# 1007/107 <br /> fW* 09-32 398 <br /> Nara.a AcRhorfrsd rlparlt slpnanue Receipt Date <br /> n_ � Nit-1 <br /> � <br /> m��! <br /> a Shipper"-Name b Shippers's-Phone No <br /> Shipperst-Address <br /> J Shippers's Special Handling Instructions and additional information <br /> :ERTIFICATION I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packagei <br /> narked,and labelediplacarded,and are In all respects in proper condition for transport according to applicable International and national governmental regulations <br />