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Waste .- No r Ac.;1~ No- ofJ9fJa 2 No <br /> 907997 <br /> S]/StemS TM OWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> OWNING-FERRIS INDUSTRIES <br /> t �,49 C Chcsr,rle4r <br /> venerator Name <br /> mid Cal <br /> l t 14, Generating Location <br /> sco kton , Ca <br /> t!ress <br /> P 0 Box 5 5 1 u 3 Address <br /> , <br /> 0,t or ktcot) , Ca 9b205 <br /> lone No <br /> 2 0 1 b 5 3 0 9 Phone No <br /> Containers Type <br /> I Waste Code 0 Drum <br /> Description of Waste Quantity Units No Type <br /> t 8❑ m 1 C Carton <br /> Cur,ti,:jvii1riated Scat B Bag <br /> T Truck <br />' ❑ J ❑ P - Pounds <br /> Y -Yards <br /> ❑ � ❑ 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, 1s not a hazardous waste as de ed by 40 CFR Part 261 or an applicable state law, has been properly described, <br />' classified and packaged, and Is in proper on Rion for <br /> nsportati accor g to applicable regulations <br /> r <br /> lci h 1r,ahart -- <br /> nuihun <br /> elur Autzed Agent Name Signature shipment Dale <br /> TRANSPORTER <br /> 916ut3f3- t�3 ib�uck Na Phone No <br /> 1�1 I F t,v z 1'or)n s i"r-,t <br /> Transporter Name Driver Name (Print) <br />[dress 3400 14,a,-ia r Vehicle License No/State <br /> L�ul i � t 7c lCa c7 + � i41t1 <br /> Vehicle Certification <br /> loreby certify that t above named material was picked up I hereby certify that the above named material was dellvefed wittl- <br /> at t¢• e r for sit ted bove o lid t the d nati listed below <br /> river Si azure Shipment Date Driver Si azure Delivery Date <br /> DEST114ATION <br /> ite Name vdsco Road Sari t:ar'V t �r,�� � � � Phone No �.--�— <br /> ddress 400 , Va cca Rc:iad, (scl y4b5U <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 /> of Authorized Agent Sr nature Receipt Date <br /> PASS CODE <br /> 0186 BF1260 720 <br /> UNLOADING AREA COPY <br /> .F <br />