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0r � WasteFERAlS INDUSTRIES AFI Acct. No. 1pl}9042 No 906030 1 S]/SternS TM NON-HAZARDOUS SPECIAL WASTE MANIFEST OWNING- GENERATOR aeneratarName Mid Cal Leasing Generating Location 1649 E Channel at dress F' 0 Box 55103 Address Stockton , Ca Stockton , Ca 95205 [one No = 6 5 6 Phone No t, 5 I Waste Code 0 9 1 9 2 e 1 9 Containers Type � ---- Description of Waste Quantic Units No T pe D - Drum C-Carton €i�ie=.e 1 Cootancinated Soil 1 8 a B- Bag T -Truck ❑ m ❑ P - Pounds Y - Yards ❑ ❑ O- Other 1 hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 or any applicable state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, classified and packaged, and is in proper cIn Rion for nsportation rdin applicable regulations ,;,,i�= 1d K Pine hat,t- C eraiar Authorized Agent Name Signature Shipment Date TRANSPORTER J �uck No � ,/ Phone No 916 668 . 9315 r Transporter Name M P Environmental Set,vi c.es Driver Name (Print) 4 ✓`L'1-C' :4-R -7vr) Ldress 'X400 Ma n o r S t i,c e t Vehicle License No/State 2 '-,?7 5 e7 — q!/00,5 N a ke r s f i e l d , Ca 93308 Vehicle Certification lereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- it the generator site listed above out incident to the destination listed below )river gnature Shipment Date Driver Signature Delivery Date ---------------------- DESTINATION � a`.ro Road San itat,y LandriI1 'ite Name Phone No —5 1 Q 4 4 L7l a�l '� ddress 4 00 1 Vasco Road , L-i varmort Ca 94 550 hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate f Authorized Agent cn nature = ece pt ate fe (__' C' i PASS CODE 186 BFI260 720 UNLOADING AREA COPY