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WasteA BFI Acct . No. lUED9042 NO 90641 MLaSystemsT BR9N1NG FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST GENERATOR Generator Name Mid Cal L eo s i n g Generating Location 1 6 4 9 E C h7 a i o a I S dress !' 0 Box 55 103 Address Stockton , Ca ,3LOL 1,t('_)rli , Ca 95205 9 - 5 6 0 9 None No 4 Phone No t A� ! Waste Code �4 0 5 1 8 1 7 1 4 0 Containers Type� Description of Waste Quantit Units No T e D Drum C -Carton Contaniineat_ed 50-11 0m 1 8 - Bag ' T -Truck ❑ m ❑ P - Pounds Y -Yards ' ❑ W ❑ O- Other I 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 properln7i7t ortatiocordrn to applicable regulations I U i\ R i natert .. L-ft,Awhonzed Agent Name Signature Shipment Date _J �uck No �~-f ��✓ Phone No 3 1 u 6 6 8 -9 3 1 6 ansporter Name F' l nit 1 r c+rzirenc ! t e� Driver Name (Print) ��r/ee��t dress ; 1 tt U M.in,sr t �C Vehicle License No/State is a k el i s 7 i e I d , Cit 93 3 U 6 Vehicle Certifica�lofl kerebycert) at the ab amed tsrial was icked u I hereb cer at thea a name a erlal was 11v r f3 p Y Y fi t delivered ed with it the ger �� r site list ove� / out cnc1 the de tion Itlxlow )river Signature Shipment Date Driver Signature Delivery Date DESTINATION Iite Name 'ia— co Road Gan i tary Land i I l Phone No 5 1 — I 7 U 4 [9 4 U i 1) asco Rood , L-i,rarinwre , 4550 #ddress hereby certify that the above named material has been accepted and to the best of my kn;q !7 the foregoing is true and accurate VMU of Authorized Agent Signature eceipi Date ` J j PASS CODE J V SF1260 720 UNLOADING AREA COPY