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i <br /> Waste No. 9 1. 1 7 <br /> Systems TV <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> i <br /> Santa Fe Railway Compnay Jersev Island <br /> Generator Name Generating Location <br /> Address 740 East Carnegie Road Address Jersev Island. CA <br /> San Bernardino, CA 92408 <br /> Phone No. Phone No. <br /> BFI Waste Code Fm-Fp-[-Tl 1 1 1 1 1 j Containers Type <br /> Description of Waste Quart units No. T pe D-Drum <br /> 1 ❑ ❑ C-Carton <br /> I 0 0 0 2 0 Y B- Bag <br /> I <br /> CONSTRUCTION DEMO LUMBER [:] F-]—] <br /> ❑ ❑ T -Truck <br /> P-Pounds <br /> Y-Yards <br /> I El ED ❑ O-Other <br /> 1 hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, <br /> classified and packaged, and is in proper condition for transportation according to applicable regulations. <br /> Generator Authorized Agent Name Signature - Shipment Date <br /> TRANSPORTER <br /> 11-3510-634-6850 <br /> Truck No. � Phone No. ^v - <br /> Dillard Trucking, Inc. 279/1 <br /> Transporter Name driver Name (Print) <br /> Address P. 0. Box 218. Vehicle License NoJState <br /> ` Byron lifornia 94544 <br /> ' Vehicle Certification <br /> I hereby certify that the -above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the generafD site listed above. ` out inciden cftfie destknation listed below. <br /> Driver Signatu , Shipment Date <br /> re over Sign lure, -:,� - Dee?'Date <br /> DESTINATION <br /> Site Name B.F.I. Vasco Road Landfill Phone No. <br /> Address 4001 North Vasco Rd., Livermore, Ca. 94550 <br /> I hereby certify that the above named material has been accepted and to the best <br /> joffmmy knowledge the foregoing is true and accurate. <br /> IName of Authorized Agent Signature Receipt at <br /> y�1 <br /> PASS CODE <br /> mic <br /> - BFl26672C <br /> --_ TRANSPORTER Rtz_TAiN <br />