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Waste BFI Acct . Nis- 1009042 No 906026 <br /> Systems TMJ&MG FERRIS 1NDUS111RlES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> Wei 4 014 <br /> Generating Location <br />� <br /> erator Name <br /> Mid Ca € Leas-inrg 1649 C Channel St <br /> P 0 B©x 55103 Stockton , Ca <br /> ddress Address <br /> ,t oc kton , Ca 95205 <br /> 0 9 —14 6 3 6 0 <br /> hone No Phone No <br />'Waste CodeFFFA U 9 1 8 3 Containers Type <br /> Description of Waste Quantit Units No T e C- Crum <br /> �n C- Carton <br /> Diesel Contaminated Soil FFTI I 8 0W Tf B - Bag <br />' T Truck <br /> ❑ m ❑ P - Pounds <br /> Y - Yards <br /> El F-10-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 properi nitron for transport i n acco rng to applicable regulations <br /> kc-mold K Rinehart [_- �rr T_ <br /> Authorized Agent Name Signature Shipment Date <br /> • <br /> ruck No Phone No 91 6 668-93 I o- <br /> nsporter Name M P 1=r�vi raremental Servs ce5 Driver Name (Print) <br /> ddress <br /> "� <br /> ddress X 4 00 Manor Street Vehicle License No /State <br /> IB l k e r s t i e l d , ( a 93308 Vehicle Certification ` <br /> hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> the generator site listed above out incident to the destination listed below <br /> a9z _ <br /> ver ignature Shipment Date Driver Sign re ^T eh ery D to <br /> DESTINATION <br /> 11tj <br /> , h it 111 7 0 t l Naiiiu _-- -- - - _ Phonu Nu _ <br /> 1 <br /> 4001 Vasco Road , Liverniore , Ca 94 55(] <br /> liereby <br /> ddre�s certify that the above named material has been accepted and to the best of my knowledge the foregor &-true and accurate <br /> me of Authorized Agent S+ nature / Racalpt date <br /> YOU <br /> PASS CAE <br /> J186 <br /> BF1260 720 <br /> UNLOADING AREA COPY <br />