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1� - ---- - - � ,4 - <br /> r --s'F-I=-Acct_ _ No t0i]90Q2__ = --n- =� No- 9 07 - -- <br /> r= <br /> Systems TM TMANIFEST- <br /> Mild <br /> FROWNING-FERRISFROWNING-FERRIS rNDUSTRIES NON-HAZARDOU S SPECIAL W AS E <br /> • <br /> Cal Leas-trig 1649 <br /> Generator Name Generating Location <br /> P 0- Box 55103 Stockton , t,F, <br />'Address Address i <br /> � r6 <br /> Phone No �— 4 6 Phone No �— <br /> 0 5 <br /> Fi Waste Code Containers Type <br /> D Drum <br /> Description of Waste Quanttt Units No 7 e <br /> i Elt m C -Carton <br /> Diesel L csntsm�nated Soil B Bag <br />' ❑ 1�_ t ❑ T Truck <br /> P Pounds <br /> Y - Yards <br /> ❑ (�� ❑ O- Other <br /> 1 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 state law, has been properly described, <br /> classified and packaged, and is in proper condition fo(Iransporta tcq according to applicable regulations <br /> 1 <br /> � r <br /> R�nefZart <br /> erator Authorized Agent Name Signature Shipment Date <br /> '916 obf3-93 ! <br /> truck No Phone No ' <br /> ransporter Name M F Fnviror)rnental Service <br /> Driver Name (Pant) <br /> - .100 S s rzet Vehicle License No/State <br /> ddress <br /> Vehicle Certification <br /> hereby certify that the above named material was picked up I hereby certtfy that the above named material was delivered with- <br /> it the generator site listed above out incident to the destination listed below <br /> Driver Signature Shipment Date Driver Signature ' Delivery Date <br /> DESTINATION <br /> 0 <br /> 1te Name `3 <br /> Phone „o <br /> Address C Vis_ rc ROad Ln _� 'tore C q�6, n <br />!hereby certify that the above named material has been accepted and to the best of —y knowledge the foregoing is true and accurate <br /> ama of Authorized A ent Si nature Receipt Date <br /> PASS CODE <br />[86 BF1260 720 <br /> GENERATOR_ RETAIN __. <br />