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lor e Waste - Nc. <br /> t TM INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR I <br /> Generator Name <br /> Santa Fe Railway Compnay Generating LocatiA�tersey Island <br /> Address 740 East Carnegie Road Address Jersey Island CA <br /> � <br /> San Bernardino, CA 92408 T <br /> Phone No. FT-71:1-1 I I I 171-1 Phone <br /> —No. <br /> TTTI — � <br /> M P T �L_LI� Containers T <br /> ype <br /> BFI Waste Code D-Drum <br /> Description of Waste Quanti Units N�o. T pe <br /> C-Carton <br /> 0 0 0 2 0 Y B •Bag <br /> T <br /> CONST/RU'CTION DEMO LUMBER T -TruckI�� El m P•Pounds <br /> El <br /> S % �,l i rf/ C l IL—IL Y-Yards <br /> j1 El m O Other <br /> I 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 /> _ 510-634-6850 <br /> Truck No. y� Phone No. / <br /> Transporter Name Dillard Trucking, Inc. 279/1 Driver Name (Print) Frwstl LC 2 6 .10 -r- Al <br /> Address P. 0. Box 218 Vehicle License NoJState <br /> Byron, California 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 generator site listed above. out incident to the destination listed below. <br /> SS `7 _�3 <br /> Driver Signature Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> Site Name B.F.I. Vasco Road Landfill Phone No. 5 1 0 —4 4 7 0 4 9 1 <br /> 4001 North Vasco Rd., Livermore, Ca. 94550 <br /> Address <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 /> Name of A mo- ed Agent Signature Receipt Date <br /> 1 <br /> { - PASS CODE <br /> 10/86 SH260-75 <br /> TRANSPC)i s';-._ ociAlN <br />