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E r E3E=E Acct . No_ 1 Qt09U4 2 Waste No 906047 � S]/Stel"M1S`�M *- NON-HAZARDOUS SPECIAL WASTE MANIFEST OWNING-FERRIS INDUSTRIES GENERATOR Generator Name cf C a 1 L a s i �l Generating Location 14 �� t h a n r i t t' %7 dress Box 55 103Address Ca t .j�_kt.orz C,;s 95205 G lone No J 2 0 ^ t 3 1 6 1 Phone No ' f Waste Code r n 4 7 M 0 9 1 1 1 21 I 3 7 51 j Containers Type Descrr tion of Waste Quantay Units No Type D Drum C-Carton (riL-�.'wl Contami nated Sot I � 1 }3 WEj B - Bag T -Truck ❑ l J 1:1P - Pounds l 1 J Y - Yards 1:1m 1:1O Other I hereby certify that the above named material does not contain free liquid as defined by 40 CFA Part 260 10 or any applicable state law, is not a hazardous waste as d fined by 40 CFR Part 261 or any applicable state law, has been properly described, classified and packaged, and is in properco dition�fgr to' sportatlon a ording applicable regulations I �ri�G Icl l� E3li�rt ),_'1- r enerator Authorized Agent Name Signature shipment Date TRANSPORTER ruck No Phone No 9 1 b 868 a 3 1 b Transporter Name M I'' Eci v-i r r,i mi ai i t_cA l Sa i v i �_ e�; Driver Name (Print) if Iddcess 3 1 tt D P�lor1t�t �i t r^e t Vehicle License No/State 6, I �_-r f i e l d , C,a 9 3 3 Cl L, Vehicle Certification hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- at the,generatorsite listed above out incident to the destination listed below J '[- lo I Driver Signature Shipment Date Driver Signature Delivery Date r DESTINATION Site Name�j "("o [kc ad rani (_ai)dt z 1 I Phone No I () -- Q 4 1 7 1,f 9 1 Address 4 00 1 'Vasco toad . Li verniar L- C d yr 150 t hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing 1s true and accurate of Authorized Age-it Si natu-rree Receipt Dat ` ! PASS CODE t 018fi a 7 BF1260 720 UN OADING AREA COPY