Laserfiche WebLink
vaste 8F1 Acct - No . 1009042 No 907994 <br /> Systems FM C NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> OWNING-FERRIS INDUSTRIES <br /> 1 �i4 an � . <br /> m I <br /> mid Cir 1 l_eas't n� <br /> generator Name Generating Location <br /> Stoc_ktoi-i , ,a <br /> I Address <br /> tress U Box , <br /> .t c:ktOn , I, 95205 <br /> Mc) � d E 3 <br /> Le Na Phone No <br /> Waste Code r A 4 tl 5 I Containers Type <br /> Description of Waste Quantic Units No Tyyyppp___e D- Crum <br /> Q C -Carton <br /> l) t���7 i.�c�nt:arno <br /> tr,ated Sil W u B - Bag <br />' T -Truck <br /> ❑ m ❑ P - Pounds <br /> Y - Yards <br /> L ❑ m ❑ O- 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 Pert 261 or any applicable state law, has been property described, <br /> classified and packaged, and is in props co diiton 10 <br /> ansport acc ing to applicable regulations <br /> s„it,:old t� f27roel7�r't �� �' , <br /> r Authonzed Agent Name Signature Shipment Date <br /> 9 1b 0t,ti 931h <br /> lick No Phone No <br /> Insporter Name Driver Name (Print) —nt) ��' <br /> dress <br /> z! p 0 Vehicle License No/State ” <br /> N i t<e r s f t e 7 d , Ca 93308 Vehicle Certification _ — -- <br /> lereby certify that the above named material was picked up I hereby certify that the above named material was delivered with <br /> At the�g'n, rator site listed above out incl enpo the destination listed below <br />)aver Signature Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> i l l t� <br /> e Name Vcc,, Lt�i�d t"cc) Road Sar)/ tar y Phone No — <br /> 77 El <br /> dress t lila 1 V,.sco kc.,& .I <br />'ereby certify that the above named material has been accepted and to the best of my knowledge oregoing 1s true and accurate <br /> Authorized A ent St nature Receipt Date <br /> PASS CODE <br /> 8 <br /> ■ + BF1260 720 <br /> UNLOADING AREA COPY <br />