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OWaste ®FI Acct - No. 1009042 No 906043 Systems Tw OWNINGFERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST GENERATOR Mid Cal Lecis i i,(i l t4 9 t_ C hari„e i 'it Generator Name V Generating Location I-, O 8C)", 55103 Str✓r 1,i'�il-) , t t' dress Address nt oc1«c;r, , Ca 8505 tone No =-1 , 16 Phone No I Waste Code g 1 1 8 r I 11 3 7 4 Containers Type Description of Waste Quandty Units No Type D - Drum C -Carton f) ts �l Cc.rst �tll, rnated 5c,7 i 1 8 E m f B - Bag { T -Truck ❑ W ❑ P - Pounds Y - Yards ❑ l 1� ❑ 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,'c ndition for tr sportati ccordtng n applicable regulations t � a,+all h f;Ir� I� ar> w e for Authorized Agent Name Signature Shipment Date i I I v tJ o 1 b 668 ruck No Phone No { M P Eriv i t ontrient a 1 bei—, i s �s L Uri} .,6 ransporter Name Driver Name (Pant) lyd ? 10t3 �1an��r `aCi set ddress Vehicle License No/State Fi'l fIeId , ca 9330rj Vehicle Certification hereby certify that the above named material was picked up l hereby certify that the bove named material was delivered with- at the en r r sit fisted above out i id t t the de alto sted below r 44 0 c� .� D D ver SIg tura Shipment Date Driver SI nature Deiwery Date DESTINATION W cj ite Name Road 3ar)7 t~ary L aridf 11 1 Phone No 0 � 4 7 0 I r 1001 Va,_c,n Beat! , L 'ivecrrior,e , Cu 94550 Address hereby certify that the above named material has been accepted and to the best of my k led the foregoing is true and accurate ell, ) of Authorized Agent Si nature /� Receipt Dale _--_n 1 6- I� PASS CODE V s� 4186 � � �--- O BF1260 720 UNLOADING AREA COPY