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r Waste No 816 93 5 <br /> SyStTRIES TM <br /> FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> BROWNING- <br /> GENERATOR <br /> Generator Name <br /> San Ca Fe Railway Compnay Generating Location .Jersey Island <br /> Address 740 East Carnegie Road Address Jersey Island CA <br /> San Bernardino, CA 92408 ITI ISI <br /> Phone No. Phone No. L—L�1J <br /> Containers Type <br /> I BFI Waste Code ❑ �� NO. Type D-Drum <br /> Description of Waste nti <br /> Qua � Units <br /> IIC-Carton <br /> 0 0 0 ® Y 0Rd T B -Bag <br /> CONSTRUCTION DEMO LUMBERC�I —Tt�I—�IlII IS�III 7tII T -Truck-1 El ❑ F] P -Pounds <br /> ' Y-Yards <br /> i ❑ ❑ El -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 Data <br /> TRANSPORTER <br /> 510-668§ " <br /> Truck No. Phone No. <br /> Transporter Name Dillard Trucking, Inc. 279/1 Driver Name(Print) <br /> Address P. o. Box 218 Vehicle License No./State 9CO t?2`gf-/ <br /> Bvron, California 94544 3Oop/d <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 t e destination listed below. <br /> 4t-"e� o / 3 9 3 \l.v�. _tl._�� ., .P , i 3 <br /> y3 <br /> Driver Signature Shipment Date Driver�ignature _ ,a.., Delivery Date. <br /> DESTINATION <br /> B.F.I. Vasco Road Landfill 5 1 0 — 4 4 7 0 4 9 1 <br /> Site Name Phone No. — <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 knp ledge the foregoing is true and accurate. <br /> Name of Authorized Agent Signature Receipt Date �' <br /> PASS CODE <br /> 10/68 - BR260-72( <br /> TRANSPORTER RFrTAIN <br />