Laserfiche WebLink
20 1 <br /> w , ON-HAZAREM SPECIAL WASTE & ESTO MANIFEST <br /> If waste is asbestos waste,complete Sections t,IL M and IV. - N O,512 4 6 3 <br /> If waste E NQI asbestos waste,complete only Sections I,U and III. <br /> '�� � ARCO PRODUCTS CgdP11NY - ARCO STATION A04932 <br /> 3enerator Name: b. Generating Location: <br /> Address <br /> POB 5077 d. Address: 16 E. HARDING <br /> SULNA PARK, CA 90622-5077 STOCKTON, CA <br /> Phone No.: (925) 29 ,-8891 PAUL SUPPLE N/A <br /> I. Phone No.: <br /> owner of the generating facility differs from the generator,provide: <br /> Owners Name: ARCO PRODUCTS COMPANY It. Owner's Phone No.: Same as I(e) <br /> C A 4 05 06 109 9 02 96 TYPE <br /> BFI WASTE CODE Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> NON—UAlARlk.WS SOIL B -BAG <br /> Description of Waste: k. Quant Units No. TYPE BA -6 MIL.PLASTIC BAG <br /> or <br /> Fro <br /> 0 0111 Y 0 1 Fn <br /> T -TRUCK WRAP <br /> O -OTHER <br /> GENERATOR'S CERTIFlCATION: 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 state law, has been property described, classed 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,1 certify and warrant that the waste has been Veale in a Pordance with t1 b requirements of 40 CFR Part 268 and is no longer a M' -CUBIC METERS <br /> hazardous waste as defined by 40 CFR Part 261. a 'I a/Te <br /> as V ARCO PRODUCTS COMPANY Y' -CUBIC YARDS <br /> MELISSA KIRK/ DILLARD ENVIRON. / /, "�.�- ' ' C, 0 -OTHER <br /> Generator Authorized Agent Name <br /> Signatunfe Shipment Date <br /> . s-a„yq"„ - ,;.� r r - • x_�ttpptr3cnID letee�>? t- °v � 'c'�ti i <br /> -TRANSI?ORTER QeneratoroomPleteat7 trans tco ata�n off.. ` <br /> TRANSPORTER I TRANSPORTER U <br /> DILLARD TRUCKING, INC <br /> Name: u In. Name: <br /> Address: L Address: <br /> BYRON, CA 94514 <br /> Driver Name/Titie: 6a- IIS `�n <br /> t «�� j. Driver Name/1-Ne: <br /> '9 —O '— PRINT/rYPE "� PRINTtrYPE <br /> Phone No.: /� e. Truck No.: � k. Phone No.: I. Truck No.: <br /> Vehicle License NoJState: q RL4a C J m.Vehicle License No./State: <br /> nowledgemennt�of R eeipt of Materials. Acknowledgement of Receipt of Materials. <br /> \ - -) D 1 (0 19Iq n. <br /> Drivers na SN mere Date Driver si bWre Shi Brent Date <br /> 0 '„f `(m , f' ..DESTINATION (Ganvrator completes a d e tinatan a completes a t.) , <br /> B-I — VASCO ROAD SANITARY LANDFILL (925) 447-0491 <br /> Site Name: c. Phone No.: <br /> Physical Address: <br /> 4001 Z4. VASCO ROAD 4001 N. VASCO ROAD <br /> d. Mailing Address <br /> LIVERMORE, CA 94550 LIVERMORE, CA 94550 <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? 1007-111 <br /> POW :9-30312 <br />