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R • <br /> Waste b BFr Acct _ No. 1009042 N� 907982 <br /> Systems TM PNING-IFERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Mid CQ I Leat ,ing 1649 t Chariiial St <br /> enerator Name Generating Location <br /> I' _ v Box 551013 Stockton , Ca <br /> ess Address ` <br /> trl.ror� , C'a 9505 <br /> te No Phone No _ <br /> 0 9 1 1 9 ? 1 3 9 5 Containers Type <br />�Waste Cade D- Drum <br /> Description of Waste Quantrt Units No T e <br /> C -Carton <br /> U I is I Contaminated Soil Lj m 1 B - Bag <br /> ❑ m ❑ T -Truck <br /> P - Pounds <br /> Y - Yards <br /> Elm 1:1O- Other <br /> 1 hereby certify that the above named material does not contain free liquid as defined by 44 CFR Part 260 10 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 prop c dation ?QFansportati n ccordl g to applicable regulations <br /> erator Authorized Agent Name Signature Shipment Date <br /> -,----- .TRANSPORTER <br /> y 1 6 668 13 3 1 6 <br />�ck No 1- Phone No <br /> M P Eriv r onmenta l W erv-� -.es Driver ransporter Name Driver Name (Print) <br /> r 100 lviar)injr' '3tt'��?t (, <br /> Less Vehicle License No /State <br /> I_.'uKersfield , Cd 93308 <br /> Vehicle Certification <br /> treby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> t thel generator site listed above out-tctcident to the destination listed below <br /> J J1 \ <br /> +yr <br /> aver Signature Shipment Date Driver ignature Delivery Date <br /> DESTINATION <br /> e Name w, "jc Road Savii tary Lands i l l Phone No `a i q — 4 4 7 i 4 9 1 I <br /> dress 4001 Vq--co Read Liverworc- , Gd 04550 <br />�ereby certify that the above named material has been accepted and to the best of mfr {aawle the JD-reg`6ing is true and accurate <br /> 0—0 Authorized A ens Si nature Receipt Date <br /> PASS CODE <br />�86 a _ 6FI200 720 <br /> UNLOADING AREA COPY <br />