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KNON-HAZARdASPECIAL WASTE &1ARESTOS MANIFEST <br /> If waste is asbestos waste,complete Sections I,R,III and W. OC n C <br /> If waste is 1� .asbestos waste,complete only Sections 1,II and III. J L J <br /> ENERATOR (Generator completes all of Section 4 <br /> w PRODUCTS COMPANY ARCO STATION #04932 <br /> t. Generator Name, i b. Generating Location: <br /> % Address POR 5077 16 E. HARDING <br /> d. Address: _ <br /> ,BUStQA PARY, CA 90622-5077 STOCKTON, CA <br /> t. Phone No.: (925) 299-6891 PAUL SUPPLE N/A <br /> I. Phone No.: <br /> `owner of the generating facility differs from the generator,provide: <br /> I. Owner's Name: ARCO PROCUCPS COl9PANy It. Owners Phone No.: Satre as I(e) <br /> TYPE <br /> BFI WASTE CODE C A4 0 5 0 6 1 0 9 0 2 0 9 6 Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> Description of Waste: - '1—HAZARDOUS SOIL B BAG <br /> k. Quanta Units No. TYPE .BA 6 MIL PLASTIC BAG <br /> or WRAP <br /> 0 0 0 y�- 0 1. ] T -TRUCK <br /> O -OTHER <br /> GENERATOR'S CERTIFICATION: I hereby cerdly clot 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 Prop"described classified and packaged, and is in proper condition for transportation according to P -POUNDS <br /> applicable regulations;AND,N the waste Is e treatment residue of a previously restdeted hazardous waste subject to the Land Disposal y -YARDS t <br /> Restrictions,I certify and warrant that the waste has been treated in a rdance with the requirements of 40 CFR Part 266 and is no longer a M` -CUBIC METERS <br /> hazardous waste as defined by 40 CFR Pan 267. Ya -CUBIC YARDS <br /> at Te este ARCO PRCIP111TT <br /> MEfiISSA KTRN/ DTT.T ARD MMR I j CN I � O -OTHER <br /> Generator Alrthonzed AgenfeNgrrle- Sgnattire Shipment Date <br /> eCA017II 'TRANSPORTER (Geeeiaorcdmpletead; Trans0rteiIImleehg <br /> TRANSPORTERI TRANSPORTER II <br /> DILLARD TRUCKI INC <br /> Name: <br /> POB 579 h. Name: <br /> Address: - <br /> BX M CA 9451'4 I. Address: <br /> Driver Name j, DriverName/Ttle: <br /> 925-634-6850 PwNrmrE PRINTITYPE <br /> Phone No.: e. �Trruck No.: It. Phone No.: I. Truck No.: <br /> Vehicle LiceNdJSfate: L I M.Vehicle License NoJState: i <br /> A eWfed m t of R pt f Materials. Acknowledgement of Receipt of Materials. <br /> g n. <br /> I <br /> Sh ment Dalo Omer Si nature Shipment Date <br /> - DESTINATION jGeneratorcompletes a-d.destination site completes ed.) <br /> Site Name.- BFI — VASCO ROAD c. Phone No.: <br /> SANITARY LAND?ILL (925) 447-0491 <br /> Physical Address: 4001 N. VASCO ROAD 40;11 (4. VASCO ROAD <br /> d. Mailing Address <br /> LIVE1tt+ )RE, ray 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 /> i <br /> Noma of Ainnorizad Agent r ` <br /> POO 09-30312 j <br /> SgneWre Receipt Date i <br /> ,yukJU3v aL.::r- - ASBESTOS Generatorcom letea-a t shi <br /> ( p g ppe'completes a.) <br /> ahlppers's•Name: <br /> b. Shippers's`Phone No.: <br /> ShlPPers's'Address: <br /> 3hiPPers's Special Handling Instructions and additional information: <br /> lTIFICATION I hereb <br /> .,o,e that the contents of this consignment are fully and accurately described above by proper shipping <br /> 14dMd labeledlplacarded,and are in all respects in proper condition for transport according to applicable international and national ao errnmental eraulationsied, packaged, <br />