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g <br /> raSystems <br /> Waste � t <br /> BFI Acct . No, 1009042 No 946028 <br /> TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • <br /> Mid Cal Leas inti <br /> Generator Name Generating Location 1649 E Charnel St_ <br /> dress <br /> P0 - Box 55103 StocktOn , Ca <br /> Address <br /> ,:�rocl- tan , Ca 95205 <br /> 36 0 <br /> ane No =—L!J Phone No �— <br /> C A 4 0 9 18 <br /> I Waste Code 3 7 4 Containers Type <br /> Descri tion of Waste Quantrty Units No T e D- Drum <br /> i-1ese I Ontarri-inat:ed Soil C -Carton <br /> 1 6 a m T B - Bag <br /> m ❑ T -Truck <br /> P - Pounds <br /> Y - Yards <br /> ❑ � ❑ 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 a plicable state law, has been properly described, <br /> classified and packaged, and is in proper cr i on for tr, portatron c ordrn o applicable regulations <br /> 1ej K R1nehart t L - <br /> or Authorized Agent Name Signature <br /> Shipment Date <br /> luck No Phone No 9 1 6 668-9316 <br /> nsporter Name Driver Name (P <br /> M 1-' Fnv� roamer-�rral Serv�ciWs In <br />(dress <br /> nnt)�` "eT mc)os �100 Manc�r' wtr,eet- <br /> Vehicle License No/State <br /> tJ,=kei,afiira id , c..a 9330I3 <br /> Vehicle Certification <br /> ereby 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 qut Tcident to the destination listed below <br /> •-moi <br />)river Signature Shipment Dale Driver Signature <br /> Dernrery bate <br /> • <br /> 'J��scO Road Sanitary Landt' r 1 1 <br />�te NamePhone No I O — 4 4 7 4 9 1 <br /> 4001 Vasco Road , Liv�rmar � , Ca 94550 <br /> lddress <br />�ereby certify that the above named material has been accepted and to the best of m owle ge the foregoing is true and accurate <br /> Authorized Agent Si nature <br /> Receipt Date <br /> 186 <br /> PASS CODE <br /> - <br /> BF1260 720 <br /> UNLOADING AREA COPY <br />