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1 Waste eFr Acct Iran_ 1009042 NO 907974 <br /> Systems TM - <br /> OWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name Mid Cal Leasing If339 t ('hann-1 5t <br /> Generating Location <br /> f U Bo -e 55103 St-(-(A.t n . Ca <br /> dress Address <br /> t c,t kL,or. , Ca 95205 <br /> lone No —14 : 1 3 6 0 lI — <br /> Phone No <br /> I Waste Code r 4 0 0 g Containers Type <br /> Description of Waste Quantit Units No Type D - Drum <br /> Li 1 k,.se I Contain I rani ed Scan l Ll I Irt �� T <br /> C- Carton <br /> L—L._I B - Bag <br /> F1 T -Truck <br /> P - Pounds <br /> Y Yards <br /> EI:I= Eim ❑ O- Other <br /> hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 26010 or any applicable <br /> state law, rs not a hazardous waste as defined by 40 CFR Part 261 or any,applicable state law, has been properly described, <br /> classified and packaged, and is in proper )dlij f ransportatr accordi g to applicable regulations <br /> 1 JKneralor Authorized Agent NameSignature Shipment Date <br /> • <br /> luck No Phone No 9 1G corp -93 to <br /> rransporter Name N P Ei,vi ronroent-a I <br /> Driver Name (Print) —__. =42 -e. <br />[dress ``r 0G h1at,or z-,treet- <br /> Vehicle License No/State 1 ZQ <br /> 13at' Id Ca 93308 <br /> Vehicle Certification <br />�ereby certify that the above named material was picked up I hereby certifythat the above named <br /> material was delivered with- <br /> it the generator site listed above out incident to the destination list d below <br /> Inver Signature Shipment Date Driver Signatur Delivery Date <br /> DESTINATION <br /> o Name '` FA- c a Read ' .,in 1 t:ar�y Land t i 1 i 5 <br /> Phone No <br /> 1tdress <br /> `1 00 1 Vasccr R add L.-varrnnrt;� , Cc 9451 O <br />�ereby certify that the above named material has been accepted and to the best of cowl ge the foregoing is true and accurate <br /> Authorized A ent EIZE i <br /> Si nature -` / Receipt Date <br /> 1( PASS CODE <br /> BFI260 720 <br /> UNLOADING AREA COPY <br />