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W Waste 13iFI Acct . No- 1009042 No 906042 Systems TM y OWNING-FERRIS INDUSTRIES - NON-HAZARDOUS SPECIAL WASTE MANIFEST GENERATOR Generator Name Mid C ,_,l Leasing Generating Location lb49 it ('f- antral 3t- }' O tax 55 103 StOchtorr , f dress Address ,t oc,kwoi) . Ca 95205 — 4 r' 3 6 0 _ one No Phone No I Waste Code t A 4 0 0 9 1 0 3 4 ' Containers Type Descrl tion of Waste Quandt Units No T pe 0- Drum C - Carton Li l asr* I t,oritcni l noted Soil 1 Ll m r B - Bag ❑ T -Truck ElP - Pounds Y - Yards ❑ �J El - Other I hereby certify that the above named material does not contain free liquid as defined by 40 CPR Part26010 for any applicable ' state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law has bean properly described, classified and packaged, and is In proper co clition f t nsportatio ccordin to applicable regulations i.t-r1.3ld IC Rll'ehar`t I C_ 1) ator Aurhorized Agent Name Signature Shipment Date Iuck No Phone No 316 bot; 9 � lea Mi p En,/-i r onrnent a I bery l i_ a �j � Transporter Name Driver Name (Print).� (C-- r �,� 17-7) r _ dress 1 al i3 C1 f41a, r, t t e e t Vehicle License No/State f 't e l c1 , i a 9 3 3 C}6 Vehicle Certification liereby c tlfy that the ove named material was picked up I hereby certify that the above named material was delivered with- it the c Pneratgr-site listed oye� gut�qident to the dest tat n listed below )nvqr ignat Shipment Date Driver Signature Delivery Date DESTINATION It' e Name `J ,_,co Road Safi1 tat,y t dr,d t i l l Phone No dress 't 00 1 Val-ICO ROdd , L -i vertiw)re Ca 94550 �ereby certify that the above named material has been accepted and to the best of �a.fcno/wle�ge the foregoing Is true and accurate G" Authorized Agent Si nature -- Receipt Date PASS CODE BF1260 720 UNLOADING AREA COPY