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NNS10 <br /> M.�HPEC AUWASDES'�;OS IAA IF ST A_i<� S,r*,+ ;`�'"��r° �. '''•''.•7'-c,:��'`y,. + —a '�' a++,\ <br /> pii�. <br /> :��-r��-=`„<��-. �t <br /> waste asbtastoswaste,complete Sections i,iI,)11 and ry e� _, <br /> waste is tW asbestos Waste,complete only Sections L Ill and m N o• L�34 <br /> a Generator Name ARCO PRODUM CQi MY b Generating Location <br /> STATION #06020 <br /> c. Addrew PM 5071 d Address 1711 E. YOSRaTE <br /> DOEM PARR, Ch 90622-5077 xmmme C24 <br /> e Phone No (925) 299-8892 PAUL SUPPLE f Phone No H/A <br /> If owner of the generating facility differs from the generator,provide <br /> ARM PRODUCTS CONlPAHY Sallee As I(e) <br /> g Owner's Name h Owner's Phone No -- — <br /> C A 4 0 5 015 3 4 9 FO 2 11016 TAL DRUM 7 �€ <br /> I BF]WASTE CODE Containers DM-ME <br /> DP -PLASTIC DRUM <br /> OW-HAZARDOUS SOIL B -BAG <br /> j Description of Waste k Quant nits No TYPE BA -6 MIL PLASTIC BAG <br /> 10101016 <br /> TRUCK <br /> Y O 1 W or WRAP <br /> I I T -OTHER ' <br /> O -OTHER <br /> GENERATOR'S CERTIHcAnON I hereby certify that the above named material Is not a hazardous waste as defined by 40 CFR Part 261 or !JNIIS <br /> any applicable state law, has been property described,classified and packaged,and is In proper condition for transportation according to P -POUNDS <br /> applicable regulations,AND,N 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 accordance with the requirements of 40 CFR Pant 268 and is no longer a M' -CUBIC METERS <br /> hazardous waste as darned by 40 CFA Pan 261 at regite of-ARCD PRODUCTS COMPANY Ya -CUBIC YARDS <br /> O -OTHER <br /> MELISSA XMX/ DILLARD ENVIRON. 107-1501 <br /> Cieneretar <br /> Authorized agent Name sig Date <br /> MR <br /> S .� <br /> 15 13MILMM, 1:1! <br /> - 7 TRANSPORTER i TRANSPORTER 11 <br /> n1L %RD TMCSCING, INC. <br /> -h Name - - <br /> ' <br /> b Aodress ___-- - I Address — <br /> BYR1011116 CA 94514 <br /> c. Driver Name/Tide __^ j Driver Name/ride - - 4 -- <br /> (925) $ -6850 PFUNT[TYPE rtiNr--- mr � <br /> d Phone No -- , -- _ --= _ - --- a-Truck No — =k:Phone No - —- - - - _-t�- I -Truck No - - <br /> f Vehicle License NodState -- - (-- m Vehicle License NoJState _ <br /> Acme g nt Receipt of Watenals Acknowledgement of Receipt of Materials <br /> 'Tj <br /> g <br /> t 7' n <br /> Drivers nahire std Dare I odd s ns Oete <br /> O BEST 0 <br /> e. Site Name <br /> BFI — VASCO ROAD SAMI`�ARY LANDFILL c Phone No� (925) 447-0491 <br />_ <br /> b Physical Address 4001 N. VASCO ROAD d Mailing Address 4001 H. VASCO ROAD <br /> LIVERMORE, CA 94550 Ll"IEW40RE, CA 94550 <br /> e Discrepancy Indication Space <br /> I hereby certify that the above named material has been accepted and to the best ofrnr edge the foregoing is true and accurate <br /> ? JOB# 1007/110 <br /> f <br /> (! PO# 09-30336 <br /> Nwne a AuftdzW Ag9M Sammie Receipt Date <br /> O �►SBEST�S � �� � l�!ea�, ���5 ;z� _ �.�`�r ., �°� ���� <br /> a Shippers%*Name b Shippers%*Phone No <br /> c Shippers's*Address _ —.._... <br /> d Shippers's Special Handling Instructions and additional information <br /> CERTIFICATION I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packag <br /> marked,and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations <br />