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NQN41AZARC&S SPECIAL WASTE & BESTOS MANIFEST <br /> K waste is asbestos waste,complete Sections 1,11,Ill and 1V No. 512216 <br /> H waste is)�Z asbestos waste,complete o%nly Sections 1 11 and III <br /> y 77 717771- <br /> c+ LN �, <br /> generator Name ARM PI40DUCTS COMPA"Y b Generating Location ARCO STATION #476020 <br /> Address FW 5071 d Address 1711 E. YOSEKIT6 <br /> BUM P"X, Q► 90622-5077 MAW17=, CA <br /> e Phone No (925) 299"BNg1 PAUL SUPPLE f Phone No N/A <br /> wner of the generating facility drffers from the generator,provide <br /> Owner's Name ARCO PRODUCTS COMPAf7Y h Owner's Phone No " rte I f e} <br /> TYPE <br /> BFI WASTE CODE 4 S 0151 1 2 9 9 2 5 0 Containers OM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> B -BAG <br /> Description of Waste NON-11AZARDMIS SOIL k Ou nt1tV units No TYPE BA -6 MIL.PLASTIC BAG <br /> or WRAP <br /> 0 o fa ! cy! o o -OHER <br /> GENERATOR'S CERTIFICATION I hereby certify that the above named matenal is not a hazardous waste as defined by 40 CFR fart 261 or UN <br /> ITS <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 a -YARDS <br /> Restnctions,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,, ,th� 'equetyt of ARCO PR"'DUCTS Ca-V%'AtJY Y3 -CUBIC YARDS <br /> _ , (IQ O -OTHER <br /> XMI68 KIRK n rW11ZON r ; ! 'j ' <br /> Generator Authorized Agent Name Signature Shipment Date <br /> _ s <br />� Ctio�i ,� _�'� r�"�� �►"��l��3T�R .�t.�rierator��teraaa,�� �ll �fir.. o � � _� <br /> TRANSPORTER/ TRANSPORTER 11 <br /> Name DnJARD <br /> TRUCKING, INC. h Name <br /> POB 579 <br /> Address t Address <br /> BY"RON, CA 94514 <br /> c„Paver NamelgtteR 7�c� j Dmrer Name/Title <br /> (925) 634-6850 MNT(r rPE PRINVIWE <br />,Phone No a Truck No _ 2 7 _ k Phone No i Truck No <br /> f Vehicle License NoJState H Q I�C~i ti m Vehicle License No/State <br />'Acknowledgement of Receipt of Materials Acknowledgement of Receipt of Matenals <br /> g Qft <br /> d I '7 `T4 n Drivers nawro sni M nate <br /> _sN Date <br /> BEI — VASCO ROAD "N IT'ARY LlkNDFILL c Phone No (925) 447--0491 <br /> a Site Name <br /> 4001 VA.':zCO RCAD 4RC1 N, VASCO I-W& <br /> Physical Address d Marling Address <br /> 1.IVtRMO F, C 94 50 L1VFk-1:-.0 C, CA 9455) <br /> r <br /> 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 100 7 1 17 <br /> rC} acs-31390 <br /> vship <br /> d Authorized Agent signature Receipt Date <br /> O ; , wv uASBESTOS d (tompiete ail,t,g,Shopper' epers%*Name b Shippers's"Phone No <br /> c Shippers's`Address <br /> Shippers's Special Handling Instructions and additional information <br /> RTIFICATION I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, package <br /> marked,and labeled/placarded and are in all respects in proper condition for transport according to applicable international and national governmental regulations <br />