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10 Waste, 8F1 Acct . Na_ 1009042 No 907993 <br /> S]/S#STRIES TM _ SPECIAL WASTE MANIFEST <br /> BROWNING-FERRIS INDUSTRIES NON HAZARDOUS S <br /> GENERATOR <br /> Mid L.aI Loosing ncl Sk- <br /> Generator Name Generating Location <br /> Iddress <br /> f- 0 Boo 55103 Address St oci "011 ' <br /> -)t c:ct ,ton , Co 95205 <br /> hone NoFT 6 9 — 4 - 6 0 Phone No <br /> 4 0 I9 i 8 3 7 4 Containers Type <br /> FI Waste Code l I - D - Drum <br /> Description of Waste Quantit Units No T e <br /> mC- Carton <br /> 01 �_se1 Con t-am7noted SraI 1 l $ a L�1�J � e - Bag <br /> T -Truck <br /> ❑ m ❑ P - Pounds <br /> Y Yards <br /> ❑ �-- (' ❑ o other <br /> hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 2601 10 or any applicable <br /> state law, is not a hazardous waste asd tried by 40 CFR Part 261 or any applicable state law, has been properly described, I <br /> I <br /> classified and packaged, and is m prope�c ndition fex transports n acc ding to appheable regulations i <br /> I <br /> J ")' _a ld h _ Rlnehdrt <br /> e rator Authorized Agent Name Signature Shipment Date <br /> • <br /> i <br /> 9 1 6 d6g-33 1 6 <br /> ruck No <br /> Phone No <br /> ransporter Name F Frivi rtonnien i o I Se v I taw Driver Name (Print) -- G �'r �'�G� XTw <br /> //, f <br /> ddress j 4 'C1 f�l�i r�at L r ee C Vehicle License No/State <br /> b a I"e r �:'f i fx I d , C d 93308 Vehicle Certification <br /> lhareby,certify ttti <br /> ove named material was picked up I hereby certify that the ove named material was delivered with- <br /> al the gneratprabove ou +ncint to theQ t anon listed below <br /> r7Fwer gnature Shipment Date Driver gignature Delivery Date <br /> DESTINATION <br /> ite Name V,r;sco Rt.jad Son 1 tary Landril i phone NoAir Ll <br /> — 1 7 C� u 1 <br /> 400 i Vasco Rood , Livermorle , t a 94550 <br /> Address <br />'hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> /r L- <br /> of Authorized Agent Signature Receipt crate <br /> PASS CODE <br />'0186 BF1260 720 <br /> UNLOADING AREA COPY <br />