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y NON-HAZAR"US SPECIAL WASTE & "BESTOS MANIFEST <br /> If waste is asbestos waste,complete Sections L 4 III and IY w,O. <br /> If waste is j=asbestos waste,complete only Sections I,II and III ,�E <br /> � r <br /> 512268 <br /> ARCD �S C�IP]1if M ' <br /> Generator Name W 3077 b Generating Location AIM STATION #06020 <br /> c Address 1' 1711 Te, YQS MITEBUM d Address <br /> P"X, CA 90622-5077 MARTECCA, CA <br /> e Phone No (925) 299--8891 PAUL SUppLE N/A <br /> f Phone Na <br /> f owner of the generating facility differs from the generator,provide <br /> Owner's Name ARCO PRIMUCTS CCHPANY Bemis as I(e) <br /> h Owners Phone No <br /> BFI WASTE CODE C t' 0 5 O 5 1 112 " 2 <br /> 1 0 5 TYPE <br /> Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> Description of Waste WOW-LIA`APJ)0II S SOIL B -BAG <br /> k Quante Units No TYPE BA -6 MIL PLASTIC BAG <br /> 0 0 0 3 or <br /> o -OTTER WRAP <br /> GENERATORS CERTIFICATION I hereby certify that the above named material is not a hazardous waste as <br /> defined by 40 CFR Part 261 or UNITS <br /> any applicable state law, has been properly described classlfled 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 ' <br /> hazardous waste as defined by 40 CFR Part 261 at: 9 M -CUBIC METERS <br /> r� �' �� A PI�CXI`:�C"'S Y' -CUBIC YARDS <br /> Prada qui il, nI UILL%AD Ew. `- { ' fO -OTHER <br /> Generator Authorized Agent Name Signature Shipment Date ' <br /> �'-#I�i11�+� P0h*_" 0enerat p� as�a T1�MIC" 111 cor <br /> Rl <br /> T Z� cn <br /> TRANSPORTER I TRANSPORTER II <br /> h Name <br /> b Address ' J '" f'4r;� �.E, <br /> �/' i Address <br /> c Diner-NameMbe I Driver Name/Title PRINTfrYPE <br /> Phone No -_ f r r' ��} PRINT/TYPE <br /> �} e!Truck No k Phone Na I Truck No <br /> Vehicle LiceW No/State m Vehicle License No/State <br /> Ackftowledgement of Receipt of M4enals Acknowledgement of Receipt of Matenals <br /> I <br /> direr n <br /> shipment nate <br /> Driver Signakm � Shipment net, <br /> r $ASCO RO&D SMIT'ARY LI�,Nffi►ILL <br /> Site Name c Phone No �a2S) 447-*491 <br /> b Physical Address �� Q d Mailing Address 4001 We VAf*O ROAD <br /> ICA 91550 LIV�O�,B, CA 94 :50 <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 /> JOBt 1007/107 <br /> fLl 1'0f 09—31396 <br /> ivarae of/4ntiordedt sipriahue Receipt nate <br /> MEW <br /> ppers's*Name <br /> -• __ b Shippers's*Phone No <br /> hippers%*Address <br /> d ShlpptafE%Special Handling Instructions and additional Inf6miation <br /> mmill- <br /> TIFICATION I 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 />