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Waste RFI Acct _ NO- 1003042 No907996 <br /> fit 1 <br /> Systems <br /> T NON-HAZARDOUS SPECIAL WASTE MANIFEST <br />� QWNING-FERRIS IC�QUSTRIE <br /> Mid Cal l C-AsIrIg 1649 E Cl'atlr,ei �r <br /> 3enerator Name Generating Location <br /> P O fic.,�, 5_ 1 G 3 �-at��cl:tar, Gu <br /> dress Address <br /> ,it Ca 95205 <br /> tone No � Phone No <br /> Containers <br /> Type <br /> I Waste Code <br /> Description of Waste Quantity Units No T e <br /> i� i sal Gc�t�t«it, titat=ed S,_3i I l �lm ❑ <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 d ed by 40 CFR Part 261 or any fpplicable state law, has been properly described <br /> Iclassified and packaged, and is in prope co ditton fo( r nsportat ccordi g to applicable regulations <br /> i t„ ,_a lci it It�iieitart C,,. 0.__ ffTa?j:� <br /> grL�for Authorized Agent Name Signature Shipment Data <br /> TRANSPORTER <br /> 916 668 9316 <br /> luck No Phone No <br /> M P Env-i i,onilient­ l 5er'”ce- Dr}ver Name ff?nn!) r� <br /> ansporter Name <br /> 1 '�;i ffl a r)C.r -,r r i;-_e r Vehicle Licen e �o/State Y <br /> dress <br /> E t ,;,r i 5 f e l d , G a 9 3 3 0 6 Vehicle Certification <br /> I <br /> ereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the generator site listed aboveout incident to the destination listed eiow <br /> lr� JJ <br /> Delivery Date <br /> isnver ignature Shipment Date er ,g,ature ,� <br /> DESTINATION <br /> '4_.C_-,a fzoad Bar1-r t tart' Lal)d ill 5 t 0 4 4 t� a 9 1 <br /> to Name �JPhone No — <br /> 4001 Vasco Road , L-ivermor,- , La 94550 <br /> Address <br /> t <br />�iereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> I Authorized Agent Si nature ecekpt ate <br /> PASS CODE <br /> UNLOADING AREA COPY <br />