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VNON-HAZAREWIMSPECIALWASTE-& ASESTOS MANIFEST If waste is asbestos waste,complete Sections I,it,III and IV. No. 512459 If waste is NOT asbestos waste,complete only Sections 1,II and III. GENERATOR'(Generator c Mptetesall otSecb6ni ARCO PRODUCES COMPaiNy ARCO STATION @04932 Generator Name: b. Generating Location: Address POB 5077 d. Address: 16 E. HARDING BUENA PARR, CA 90622-5077 STOCKTON, CA Phone No.: (925) 299-8851 PAUL SUPPLE, f. Phone No.: NSA wrier of the generating facility differe.from the generator,provide: Owner's Name: ARCO PRODUCTS COMPANY Same as I(e) h. Owner's Phone No.: BFI WASTE CODE C A 4 0 5 0 6 1 0 9 9 0 2 1 0 9 b L Containers DM-METAL DRUM DP -PLASTIC DRUM NON—HAZARDOUS SOIL B -BAG Description of Waste: k. Quantity Units No. TYPE BA -6 MIL.PLASTIC BAGor I lfl T -TRUCK WRAP O -OTHER GENERATOR'S CERTIFICATION: I hereby certify that the above named material is not a hazardous waste as defined by 40 CFR Part 261 or UNITS any applicable state law, has been property described, classified and packaged,and is in proper condition for transportation according to P -POUNDS applicable regulations;AND,N the waste Is a treatment residue ef'h previously restricted hazardous waste subject to the Land Disposal y -YARDS Restrictions,I certify and warrant that the waste has been d ed' accordance wa the requirements of 40 CFR Part 266 and is no longer a M' -CUBIC METERS hazardous waste as defined by 40 CFR Part est. 6f -� [ of ARCO PRODUCT CO A Ya -CUBIC YARDS j I l O -OTHER - MELISSA RIRN/ DILLARD %•' , i Generator Authorized Agent Name Signature Shipment Date IetionII TRANSPORTER Generatorcom plate ad; TTrans et ranspotei7canpbteeg Il com el TRANSPORTERI TRANSPORTERII Vame: DILLARD TRUCKING, INC. h. Name: address: POB 579 i. Address: B «v. m salla hiverNameltAfe, .---7 j. -Driver Name/T'Ne: — i 925634--6850 wNrmPE PRIWfTWE 'hone`No.: n e. Trude No: k. Phone No.: I. Truck No.: /ehicle U rise No./State:. Gs Y 7g o m.Vehicle License NoJState: 1c dgem t of R ip of Materials. Acknowledgement of Receipt of Materials. i n. I nature SN Ment Date Dwer SignaWre Sri merit Date Ctlon;III ,-v DESTINATION .(Generator completes ad,destinatiodshe completes e-f.) lite Name: BFI — VASCO ROAD SANITARY LANDFILL c. Phone No.: (925) 447-0491 4U01 N. VASCO ROAD I 'hysicel Address: d. Mailing Address 4001 N. VASCO ROAD i LIVE'Rr10RE, CA 94550 LIVERMORE, CA 9450 discrepancy Indication Space: II hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. JOB# 1007-111 oma of Aulftorrzee Agent Si nature - P01f 09-30312 g Receipt Date i :tion IV A$BE$TO$''.(Generator complete a-d,f,g,Shipper•.completes e.) hippers's•Name: b. Shippers's"Phone No.: i hippers's'Address: I hippers's Special Handling Instructions and additional information: I TIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packaged, ed,and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental re0ulations.