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VVd5Xe• No. .1 bU n ! <br /> Systems TM <br /> ERRIS INDUSTRIES NDN-HAZARDOUS SPECIAL WASTE MANIFEST <br /> aROWNING-F <br /> GENERATOR <br /> Generator Name <br /> Santa Fe Railwav Compnay Generating Location Jersey Island <br /> Address 740 East Carnegie Road Address Jersey Island, CA <br /> San Bernardino, CA 92408 <br /> Phone No. Phone No. FTI <br /> BFI Waste Code ❑ k7V-D I T I I ' I I I I I I Containers Type <br /> Description of Waste Quanti Units No. Type D-Drum <br /> 0 0 0 1 8 ❑Y = T C -Carton <br /> I � I u B -Bag <br /> CONSTRUCTION DEMO LUMBER ❑ F-1-1 ElT -Truck <br /> P-Pounds <br /> Y-Yards <br /> ❑� ❑ —1 El •Other <br /> 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 /> .I <br /> Generator Authorized Agent Name Signature - Shipment Date - <br /> TRANSPORTER <br /> Truck No. V C,, 510-634-6850 - <br /> Phone No. <br /> Transporter Name Dillard Trucking, Inc. 279/1 , <br /> Driver Name (Print) i I <br /> �t Jn}q 'r <br /> Address P. o. Box 218 Vehicle License No./State V V/ 9' -�o <br /> Byron. California 94544 .y <br /> y Vehicle Certification ( L` i <br /> 1 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 /> DriverSgnatureShipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> Site Name B.F.I. Vasco Road Landfill Phone No. <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 of my knowledge the foregoing is true and accurate. <br /> Name of Authorized Agent Si nature -4 Receipt Date <br /> PASS COD€_ <br /> 10/W <br /> BF1260-720 <br /> TRANSPORTER RET4"' <br />