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Waste <br /> p <br /> sf=r a��t _ fyc�_ ioosoa2 N� 9D6023 � <br /> Systems TM , <br /> FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> ' Mid Cali._eas�tti� <br /> enerator Name Generating Location 1 6 4 9 E Channel S t- <br /> ddress� <br /> Ct E3ox 55103 Address Stockton , Ca . <br /> SLOckton , Ca . 95205 <br /> Q 9 — 4 5 3 6 Q <br /> hone No Phone No �— # <br /> BFI Waste Code A 4 i7 0 1 5 Containers Type <br /> Descri tion of Waste Quantrty Units No Type D- Drum <br /> 8 m C -Carton <br /> L� I esel Cantarninated Sol l B -Cag <br /> ❑ m ❑ T -Truck <br /> 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 an ,applicable state law, has been properly described, <br />' classified and packaged, and is in proper,co dation I¢r`transport alcor }ng to applicable r gulatlo s <br /> -I d K Ri nefiar,t � ( � 1 I <br /> l/ <br /> enerator Authorized Agent Name Signature Shipment Date <br /> I <br /> ruck No d Phone No 9 1 6 668-9316 <br /> Transporter Name M ' Env r an meati t a l Se r v c es Driver Name (Print) Al ! � ��✓ <br /> Iddress 346,0 M,�ntjr­ Street <br /> Vehicle License No(State <br /> f10d , Ca 93308 <br /> Vehicle Certification <br /> 1hereby 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 /> i <br /> Driver Sig at re Shipment Date aver Signature Delivery Date <br /> DESTINATION <br /> I <br /> Vasco Road Sanitary L zind f i l l 1 0 — 4 Q 7 <br /> Site NamePhone No 9 1 <br /> Iddress 4 t]0 1 Vasc,-3 Rc_)ad , L i verniorre, Ca 94 5b0 <br /> hereby certify that the above named material has been accepted and 7:Z <br /> knowledge the fore s true and accurate <br /> i Authorized A ent Si nature Receipt Date <br /> —� <br /> • PASS CODE <br /> terse <br /> SF12sn 720 <br /> UNLOADING AREA COPY <br />