ARCHIVED REPORTS XR0001475 - Laserfiche WebLink

Home Browse Search

i r Waste 8FI Acct . Na_ 1009042 No 906050 B Systems TM NON-HAZARDOUS SPECIAL WASTE MANIFEST si Generator Name Ni Id Cal Leasing 1649 E Channiaa I �t Generating Location JAddress F' 0 Bt» Address . 55 10 i ,tc„�Ictor, C ca `it oc;ktrin , Cci 95205 'Phone No f 9 — A £ -1 ".1.0 5 F] Phone No c. A' 0 G 9 l t3 `� t 9 Containers Type BFI Waste Code � � Description of Waste Ouantit D - Drum Units No T e C -Carton tl ir. se-I Coritzjsssji-sated Stmt ! LL.. L A [ B - Bag �� ❑ m ❑ T Truck P Pounds Y -Yards ❑ m F] O-Other 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 propeigco ditton fc ansportaUo ccordi to applicable regulations ICt.ilra �ld h l in=har't razor Authorized Agent Name Signature Shipment bate � r r 'Truck No Phone No 9 1 6 668 -931b 1�1 p iv r�onrrsentu 3 &,er,. -tG l Transporter Name EtDriver Name (Print) Address 340U 0 M ri o r to t r' e t Vehicle License No/States R Itis s f t e I`I ' C'a 5 0.3 0 6 Vehicle Certification I 5 I hereby certify that the above named material was picked Y p up I hereby certify that the above named material was delivered with- at the generator site listed above out incident to the destination listed below � yzztiz - vz � sz -Dever Srgp t e Shipment Date 4__ ure Dehtiery Date 6 f DESTINATION Site Name J"j–c'c.) Pond SanItat-y LdndfiI I Phone No 1 00 I Vasco Rood , L7 vei-nior e C a 94 � Address � 94 ,350 hereby certify that the above named material has been accepted and to the best of my knowledge the fore is true and accurate RE of Authorized A nt S nature �, p e i lL110!86 "�d (7 PASS CODE /7 � � UNLOADING AREA COPY 6FE260 720