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Waste No. a lID J <br /> SySteS TM NUN-HAZARDOUS SPECIAL WASTE MANIFEST <br /> BROWNING-FERRIS INDUSTRIES <br /> Jersey island <br /> Santa Fe Railway Cempna5' Generating Location <br /> Generator Name <br /> Address <br /> 740 East Carne ie Road Address .lersev Island CA <br /> TISall Bernardino, CA 92408 <br /> Phone No, LTJ Phone No. <br /> j r`�. � `, � Containers Type <br /> BFI Waste Code m l� P F T FT= D-Drum <br /> Description of Waste Quantity Units No. <br /> T C-Carton <br /> 0 0 0 Q 0 / Tl B-Bag <br /> T -Truck <br /> CONSTRUCTION DEMO LUMBER ❑ m ❑ P - Pounds <br /> Y-Yards <br /> 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 trans according to applicable regulations. <br /> Signature ShlpmeM Daze <br /> Generator Authorized Agent Nanre 9 <br /> TRANSPORTER <br /> 7 q <br /> Phone No. 510-634-.6850 . . <br /> Truck No. l� F <br /> Transporter Name <br /> Dillard Trucking, Inc. 279/1 . Driver Name(Print) Jl� <br /> LIZU g2 Gq <br /> Address P• O. Box 218 Vehicle License NoJState <br /> Byron, California 94544 Vehicle Certification db 41149 <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' cident to the destination listed below. <br /> SDrive im <br /> P x ! J41M <br /> `/vt k, ti <br /> - ,*) / / `J / <br /> Signature Driver Signature Delivery ry Date <br /> Date <br /> DESTINATION <br /> Site Name <br /> B.F.I. Vasco Road Landfill Phone No. 5 1 —F4=0 4 9 1 <br /> 4001 North Vasco Rd., Livermore, C. 94550 <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best off m��dge_>eforegoing i and accurate. <br /> Name of Authorized Agent <br /> Signature ReOWLAData <br /> - PASS CODE <br /> tv BFI260-T. <br /> f <br /> t TRANSPORTER RETAI^! <br />