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Waste _ BF? Ac^r NC% t (11iQi7A J No Q7990 - <br /> µ Systems TM <br /> ROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> i <br /> • <br /> I <br /> Mid Cal Leasing1649 E CharineI SC <br /> enerator Name _ Generating Location <br /> P' 0 Box 55103 Stocl-tcin r a <br />�ddress Address r <br /> St c,cktrn , C95'05 <br /> 2 9 55 6 G, 9 <br /> hone No d Phorie No'� <br /> BFI Waste Code <br /> 4 0 1 5 1 ] 1 11 S 3 ? 1 4 19 r j Containers Type Description of Waste Quantity Units No Type D - Drum <br /> C -Carton <br /> DIC-se, C'or r cm-i r'a te'r 1 t <br /> B - Bag <br /> T -Truck i <br />' ❑ m ❑ P - Pounds , <br /> Y -Yards <br /> u - r <br /> ❑ m E <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, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable slate law, has been properly described, <br /> classified and packaged, and 1s in proper condition for 1tansportatlon-according to applicable regulations <br />''enerator Authorized Agent Name Signature Shipment Date <br /> • <br /> ruck No a�t �O`1 Phone No <br /> h1 P Env� r �rir;,entz� ServiceF <br /> Transporter Name Driver Name Print _- l nL <br /> 14400 Manoi, <br /> ddress -- - - - - -- Vehicle License No /State t <br /> Vehicle Certification <br />(hereby 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 above out Incident to the destination listed below <br /> f <br /> J "d <br /> f l <br /> Drive,Signature Shipment Date Driver Signaiure Delivery Date <br /> DESTINATION <br /> vawro RoAo `3an� r ry t = ,df, l '1 5 t 4 4 2 t <br /> l-ite Jame Phone No �� - - <br /> { r <br /> dd.mss <br />�eicby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> Authorized A eni Si nature Receipt Date <br /> f <br /> r� <br /> PASS CODE_ <br /> �6E BF1260 720 <br /> GENERATOR RETAIN <br />