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1 <br /> Waste 'gFI Acct - No- 1009042 No 907988 <br /> n <br /> Systemr*.TMij, <br /> BROWNNON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Mid Gad t_�a��ing 1649E Cf;�nr�el It <br /> generator Name Generating Location <br /> 0 Box Wa 103 aLcacl,tnn , Ca <br /> Iress Address <br /> 4 <br /> mak—,C,NtC,n , Ca 95205 <br /> Jone No 4 6 3 6 0 <br /> Phone No <br /> Waste Code { A 4 f) Containers Type <br /> Description of Waste Quantity Units No Type D- Drum <br /> Cont-an 7natod 5011 D m C - Carton <br />' u B - l3ag <br /> T -Truck <br /> E:E= El F1 <br /> P - Pounds <br /> Y - Yards <br /> V. <br /> El F-10 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 properldoCclition transporta accor ing to applicable regulations <br /> i..14ald h Rinehar't 1 <br /> r Authorized Agent Name Signature Shipment Date <br /> lick No <br /> Phone No <br /> nsporterName M P Erivii-iiSer zc � T_�� <br /> Driver Name (Print) <br /> dress J�tda hlsr�t�r :at <br /> Vehicle License No /State <br />' t� } +✓, ;f i t cl , <br /> Ca 93308 <br /> Vehicle Certification <br /> hereby certify that th above named material was picked up I hereby certify that the above named material was delivered with- <br /> h gen #or site ted above ou71 !,de t #a the des atron listed below <br /> -112 1q1 ,D1 <br /> Iver signature Shipment Date Driver Si ature Delivery Date <br /> DESTINATION <br /> Name J""c�'T' Read Saiz i tary t al;c.Ifi 1 7 1 0 <br /> Phone No — <br /> ddress EET= <br /> 4 00 1 Vasco Road , L i ver'moi e , Gc, 94 55 0 <br />�reby certify that the above named material has been accepted and to the best of m �!70 0 dg the foregoing is true and accurate <br /> Authorized Agent Si nature G <br /> i �olt <br /> r <br /> PASS CODE 6 BFI26D 720 <br /> UNLOADING AREA COPY <br />