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Waste 1311=I Acct _ No- 1009042 No 907989 Systems TM . n BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST GENERATOR Mid Cal Leasiri 1649 6 C fi�zrtr7� I Sr Generator Name Generating Location F O Bo-, 55 103 StocKtcin , C,,j dress Address 95205 2 0 913 3 . Phone No 51 1 1Phone No I ITI FI Waste Code m 3 1 2 3 7 i 5 Containers Type Descrl tion of Waste Quantit Units No pe p - Drum C - Carton l�3wel L uiltc�itll noted Soil I S m 7 B - Bag m T - Truck P - Pounds Y - Yards ❑ � ❑ O- Other I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 or any applicable ' state law, is not a hazardous waste as defined by 40 CFR Part tel or an applicable state law, has been properly described classified and packaged, and is In properrco itlon f transportat n acro d ng to applicable regulations Id h h'�n tics t ` 11_- RF�g I for Authorized Agent Name i g Signature Shipment Date • yI `ruck Na ✓G �� / Phone No `3 1 6 b 6 B 9 3 1 6 M P E-ov t r Gnlftr=nt4a l Ser v i c. � ansporter Name Driver Name (Print) s�! (JU (/1::) C r ecr J� / /' Idd ress Vehicle License No/State �'- ls�iL,er�� i ielcl Ca 93308 Vehicle Certification hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with at the yeiierator site listed above uut incident to the debtinatlon li5led ow Deverignat re Shipment Date Driver Sr natur �� 9 Delivery Date DESTINATION J,.,� o Poad �1an f tc,r V I aEnd7. 7 1 1 �ite Name Phone No 4 00 1 Vasc. Q Fuad , Livermort- , 94550 Address hereby certify that the above named material has been accepted and('to the best of my knowledge e fore�ojng+s drure-and accurate f Authorized Agent Signature O Receipt Date PASS CODE BFI260 720 UNLOADING AREA COPY f