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,BION=MAfAREC1JS SPi6lAL,WASTE-& f--�BESTOS��,M I��S�� 3 <br /> -1-r If waste Is asbestos waste,complete Sections I.IL III and ry w'O.512233���� <br /> �. If waste Is M asbestos waste,complete only Sections I,H and III. Ir <br /> nerator Name ARM PPODV TS OOleMY AAROD MMTION 006020 <br /> b Generating Location <br /> Address 8 d Address 1711 E. Y0SRKM <br /> UUM PARK, Cly 90622--5077 HANTEM CA <br /> Phone No (925) 299-8891 PAUL SUPPLE" f Phone No N/A <br /> of the generating facility drifters from the generator,provide <br /> T ^ <br />�ier's Name ARCO PRODUCTS COMPANY h Owner's Phone No t'ai,aml3 as I(e <br /> TYPE <br /> I WASTE CODE C A 4 0 5 0151 21419 9 O 2 6 '7 Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> B -BAG <br /> peon of Waste NON—RAZARDOUS SOIL k Qu trty Upas No TYPE BA -6 MIL.PLASTIC BAG <br /> or <br /> 0 0 01151 <br /> H a l T -TRUCK <br /> 0 -OTHER WRAP <br /> VENERATOR'S CERTIFICATION f hereby certify that the above named nistenal is not a Hazardous waste as defined by 40 CFR Part 261 or UNITS <br /> any applicable state law, has been property described dassirred and packaged,and is in proper condition for transportation according to P -POUNDS <br /> &OplKmble:1"111 <br /> ulations,AND,H the waste Is a treatment residue of a previously restricted hazardous waste subject to the Land Disposal Y -YARDS <br /> and warrant that the waste has been treated in accordance with the requirements of 40 CFR Part 268 and Is no longer a M3 -CUBIC METERS <br /> as defined by 40 CFR Part 261 3tn <br /> x eaqu t3 of ARCO Y3 -CUBIC YARDS <br /> t51-2 1515 1 O -OTHER <br /> nerator Authorized en1 Name Sig Shipment Date <br /> y TRANSPORTER I __- TRANSPORTER 11 <br /> sk - fl1.I+ARD TRUC�CMe INC' h Name <br /> „r, <br /> Address ;'r�-- __ I Adilress <br /> `Cik 94514 <br /> it Driver NameMliede j11 Driver NameMde <br /> (925) 634-6850MNTnwE <br /> tide <br /> ne No a Truck No- k Phone No I Truck No <br /> License No/State 7 Z_ m Vehicle License NoAtate <br /> Adcno+ry ge tit f Recelpt r Matenals Acknowledgement of Remipt of Materials <br /> ZM u 12-1 <br /> n <br /> orlver _ I I I 1= <br /> nail" orate odver Signature sh oete <br /> $ i, mpl�tesMIRA <br /> ;oesdnaai� r <br /> Name EPI "' VASCO ROAD SANITARY LANDPILL c Phone No (925) 447-0491 <br /> rical Address 4001 N. VASCO ROAD d Mailing Address 4001 N. VASCO ROAD <br /> LIVERMORE, CA 94550 LIVFPMORE, CA 94550 <br /> Discrepancy Indication Space <br />�reby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> JOB# 1107/110 <br /> rrst- <br /> sere Hemp oats <br /> PO# 09-30:336 <br /> F m��' 3 r t <br /> 5� l5 (Genert?roifipieta ate,�,;g, iPpe�oompTeese � - � � <br /> b Shippers'&*Phone No <br /> strippers'&Special Handling Instructions and additional information <br /> [CATION I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packaged, <br /> and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations <br />