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� o <br /> P he <br /> ' Waste BFI Acct . Na_ 1009042 No 90 1984 <br /> Systems TM <br /> I()WNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Niki Coal Leas i r)q 1b49 E Cftarir el ;.at <br /> enerator Name Generating Location <br /> 11 0 BOX 55100 Stockton , ( a <br /> ess Address <br /> Ca 9520b <br /> te No — 3 6 J Phone No � � <br /> 4 I 5 0 9 1 9 2 LEI <br /> 9 5 Containers Type <br />'Waste Code D - Drum <br /> Description of Waste Quanti Units No Type <br /> C- Carton <br /> [itvsl Contaminaved Steil 1 8 a m 1 B - Bag <br />' T -Truck <br /> ❑ W ElP Pounds <br /> LTJ 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 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 prope(1!;n <br /> tran�por tion ac oyding to applicable regulations <br /> �� �r��,lif lC R7no13tlrt <br /> r Authonzed Agent Name Signature Shipment Date <br /> J <br /> i t 9 1 6 668-9316 <br /> Ick No Phone No <br /> I.1 P I:�nv� r,�i rficerita1 �erv�r�- <br /> nsporter Name Driver Name (Print) <br /> dressQ3400 ��lc�t`i,ar st_r�u�r Vehicle License No ISilatOB 1 t ?�C) <br /> 1 E, ,1,�,r � f ,eld , Ca 931013 <br /> Vehicle Certification <br /> ereby certify that the above named material was picked up I hereby certify that the above named material was delivered with <br /> it 1�e generator site listed above out incident to the destination listed below <br /> Inver Signature Shipment mate Driver Signature Delivery Date <br /> DESTINATION <br />� <br /> te Name'a-,co Noad Sar) iL iry t_an # t 1 1 Phone No Q <br /> 5 I — 4 Ll 4 1 4 I <br /> ,i utr l Vasco Road , Livet,iriorc r c a 441) Do <br /> kddress _ <br /> ereby certify that the above named material has been accepted and to the best of my know) the foregoing is true and accurate <br /> f Authorized Agent Si nature Receipt Date <br /> ~�~J~ PASS CODE <br /> !86 <br /> BF1260 7,�0 <br /> UNLOADING AREA COPY <br />