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o� <br /> NON-HAZARDOUS 1 <br /> Waste AFI Acct - No. 1009042 No 907978 ri <br /> Systems TI <br /> ROWNING FERRIS INDUSTRIES SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> !+$1c1 ( � ! Leal-- ts�tj 1b3eJ k.. (.,l,or,tj�� I _)t <br /> IdName Generating Location <br /> IAddress <br /> ',t r'c.hton ' Cd 95205 <br /> tone No I I Phone No �— <br /> FI Waste Code ' Containers Type <br /> Descrlpfron of Waste Quantity Units No Type D - Drum <br /> f 7c-_81 Gc,ntdrtiinaLeci Sol1 C - Carton <br /> t >3 1 B - Bag <br /> T -Truck <br /> ❑ m ❑ P - Pounds <br /> Y - Yards <br /> ❑ I� ! ❑ O- Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 or 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 prop,?"c nditlon Nransportation accor i�g to applicable regulations <br /> Kkt4 rld K Ptri hart <br /> 1-� <br /> 3nerator Authorized Agent Name Signature Shipment Date <br /> ruck No a Phone No 9 1 6 1568 _93 1 6 <br /> M P Environmental Sery i c=F � <br /> ransporter Name Driver Name (Print) <br /> 3tf1U 1�lcrii�l 'at�'�ti ��'� <br /> iddress Vehicle License No/State — <br /> t"til �r&' f Iti.Id CA 9330Fj <br /> Vehicle Certification <br /> hereby cerxrfy that the above nam�ed�naterral was picked up I hereby ce 'fy"hat the above named xrrtenal was delivered with <br /> - <br /> ,9d <br /> the generator site sf�d above out road jo the desti !�n liste�}�efow <br />]aver Signature Shipment Datev[�r Signaa u a Delivery Date <br /> DESTINATION <br /> r� . s hoad Sari i tai-y L,=i d 1 i 1 1 <br />�Ite Name V­ <br /> Phone No <br /> ddress 1 t)0 1 Va5cc) I<oaJ L9varrmDi-e , C 6 cr 1 b 5 U <br />(hereby certify that the above named material has been accepted and to the best of my knowled a the f9jegoing is true and accurate <br /> Authonzed A ani __a <br /> Signature PeceiElal � <br /> Wo- <br /> PASS CODE <br /> 186 BFI260 720 <br /> f _ r <br /> UNLOADING AREA COPY <br />