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i Waste o <br /> Systems TM 8F1 Acct . No_ 1089042 NO 947976 <br /> ROWNING FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> Generator Name Mid Cal Leosing 1649 C CI �t- <br /> Generating Location <br /> �ddress I t' Bon 66103 atcjcl�tn-, , c <br /> Address <br /> at 0C'itito t) , ('a 9520 i <br /> Rhone No 0 5 6 <br /> • Phone No —L. <br /> FI Waste Code �' A � ETH= <br /> 37 ,� <br /> Containers Type <br /> Description of Waste Qrl�l <br /> Units No Type D - Drum <br /> i t1 Contari�7riated So-, I 0D 0 C- Carton <br /> B - Bag <br /> EF= ❑ ❑ T -Truck <br /> P - Pounds <br /> Y - Yards <br /> ❑ (�-���� ❑ O- Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260110 for any applicable <br /> state law, is 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-cditron transporta to accor ing to applicable regulations <br /> r <br /> ici K Rirlei)rar`r C <br /> eneralor Authorized Agent NameSignature <br /> Shipment Date <br /> ruck No S S Phone No 9 1 o 6 6 6-9 3 1 6 I <br /> ransporter Name M P Envi ronriter,ra I SSI rw � r <br /> Dever Name (Print) <br /> ddress "4 00 Ma o '--- trteer_ <br /> Vehicle License No(State <br /> H I�et h iE� l �l , t � 93106 <br /> Vehicle Certification <br /> hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- f <br /> at the generator site listed above out incident to the destination listed below <br /> ure Ss ria ure Shipment Date Dever Signa ure <br /> Delivery Date <br /> a <br />�ite NameV,JE r Ro , d San i t•ar�,/ Landf 7 I1 1 0 d 1 t) <br /> Pham No <br /> Address 4 u 0 1 Va�::'CC. Foal , LaVei _ Ca !4 `x50 <br /> hereby certify that the above named material has been accepted and to the bes $f-my wledge t -feregoing Is true and accurate <br /> Authorized A e Si at r <br /> ] Receipl Date <br /> PASS CODE <br /> ~ BF12b0 720 I <br /> UNLOADING AREA COPY <br />