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OWNING-Fa 4 Waste �° ' <br /> BFI Acct . No- 1009042 No 907981 <br /> Systems TAA -ERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br />.generator Name Mid Cal bees i nc3 1 b4lj F Cizanri�a 1 St <br /> 11 Generating Location <br /> ress <br /> f' r) Box 55103 Address Stockton , Ca <br /> SLOCI- ton , Ga 95205 <br /> -' 9 — 4 8 6 0 9 _ <br /> tne No Phone No <br /> Waste Code 4 0rJ I 1 8 4 Containers Type <br /> Description of Waste Quantity Units No T e D- Drum <br /> C - Carton <br /> Diesel Contarn i n�ted Soil I m 1 B - Bag <br /> T -Truck <br /> ❑ m ❑ 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 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 propep co drtion f nsportatl ccordi to applicable regulations <br /> I'c'[1 016 Ik Rinehart: <br /> � Z <br /> erator Authorized Agent Name Signature Shipment Date <br /> • <br /> lick No Phone No 9 1 6 6b8-9316 <br /> M P Env-ironmental <br /> ransporter Name Sri vicGS <br /> Driver Name (Print) �� <br /> Lress 3 1 0 0 friar ,o r St r,e c=t Vehicle License No(State <br /> Bakersfield , Ca 93308 Vehicle Certification <br /> reby certify that the above named material was picked up I hereby certify that the above named material wasII <br /> de vered with- <br /> the generator site listed above out Incident to the destination listed to <br /> /1 <br /> // �� / A / <br /> Ivor SignalAiYoShi ment Delu ..w <br /> p Driver Signal Delivery Dere <br /> f <br /> DESTINATION <br />( Name Vf1sc0 Road San i tarry Landt i l l Phone No <br /> dress 4001 Masco koad , Li verrncrr W , C 9 5 b 0 <br />�reby certify that the above named material has been accepted and to the best of my knowled e t of regoing is true and accurate <br /> Aft <br /> uthonzed A eni <br /> Signature ReCelpl Dat <br /> IfJ' <br /> PASS CODE <br /> 6 SF1260 720 <br /> UNLOADING AREA COPY <br />