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OROWNWasteBFI Acct . No- 1009042 No 906032 <br /> Systems TM <br /> ING-'IFERR[SNON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> INDUSTRIES <br /> GENERATOR <br /> Mid Cal Leasing 1649 E Channel St - <br /> Generator Name Generating Location <br /> Iddress <br /> P 0 Bax 55103 Address Stockton , Ca <br /> D oc kton , Ca 95205 <br /> hone No Z 0 sP <br /> 6 Phone No <br /> FI Waste Code 0 A 14 � I ] 0 9 1 _ 1 1 l21 l Containers Type <br /> Descrl tion of Waste Quantity Units No T e D- Drum <br /> C- Carton <br /> Die-se-1 Contaminated Soil f 13 � � B - Bag <br /> T -Truck <br /> ❑ m ❑ P - Pounds <br /> Y -Yards <br /> F] m El - 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 properlCo?Kiition fortnsportatto cordin to applicable regulations <br /> K(aia Id K . R-Inefiart 1 ;7)� � � <br /> eneraior Authorized Agent Name Signature Shipment Date <br /> { • a <br /> ruck No T! �J• 0 'd Phone No 9 1 6 668-9'31 i <br /> r <br /> M N Envi ronmen rd l S. -v-ices `� --�` <br /> Transporter Name Driver Name (Prfnt,L IA 1'A <br /> Address Vehicle�1 C]0 Manor, S t r eat Vehicle License No/State <br /> Bakersfield , C a 93308 Vehicle Certification <br /> II hereby certify that the above a ed material was picked up I herBby ertify that the aboye named material was delivered with <br /> at the q rerator sit flsfed a v , out incid6nt to tete destln iori,llsted below ' <br /> rf <br /> Drr 9lgnature (shipment Date �-�_LwKe-r Signature Delivery Date <br /> DESTINATiON <br />,Site Namev"8co Rood Sari r_ary L,andf r 1 l Phone No 1 —1 41 .4 1 1 9 I <br /> Address 001 Vascao Road , Livermooe , Ca (48550 � <br /> I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoin _1,j-1rue-end accurate <br /> E of Authorized Agent Sinature Recefpf Dat <br /> I <br /> PASS CODE <br /> 10186 �D BFI260 720 <br /> / UNLOADING AREA COPY <br />