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nZOWNING-FERRIS <br /> Waste <br /> `_'Fr Acct . tic 1004042 NO 906020 <br /> Systems TM <br /> INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • <br /> `end Cal !c=_;_ � , 164Q <br /> eneralor Name Generating Location <br />'ddress F $o" 55103 Address Stockton , Ca <br />'hone No - Phone No —1 L <br /> -Fl Waste Code <br /> t l r g ' r ' 11 3 Containers Type <br /> Description of Waste Quantit Units No T pe D - Drum <br /> - ❑ C Carton <br /> B Bag <br />' ❑ i J ❑ T - Truck <br /> P - Pounds <br /> YYards <br /> El El �T F-10 Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260W10 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 for transportation according to applicable regulations <br /> Poi��iG 11 RInf---h arr E ET-1 <br /> n2ratOr Aulhorrzed Agent Name Signature Shipment Date <br /> Tuck No <br /> Phone No <br /> ans orterName I �° wry-i -c+r�r�� -r Ser4ic== U <br /> p Driver Name (Print) <br /> dress 7' ICO Manor <br /> Vehicle License No IStatezS 2 Z S YT - 1&9 S O O _5 <br /> 8 a i�e's f C`i ~`i 0` 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 /> t the generator site listed above out Incident to the destination listed below <br /> Iver S7sgnature Shipment Date Dn er Signature Delivery Date <br /> DESTINATION <br /> le Nam Vas ca Pr3ad 3 to y Landfi I i Phone No =— d a 7 g I <br /> ddress 417i3 c_� r Z"�: , I .SL--r,iorE- GFi 94 ,950 <br />�reby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> a <br /> Authorized A ent Si nature Receipt Dete <br /> PASS CODE <br /> r <br /> OR260 720 <br /> GENERATOR RETAIN <br />