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I01' �Waste =C1 AcL- 1<47, n� 4 <br /> , t3 00- No 906023 <br /> Systems r>" <br />(BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • <br /> Mid Cal <br /> generator Name Generating Location r`l <br /> Address - <br />�ddress F r, Bow 55 , 0 <br /> 510 _ Stocktc+n , Ca <br /> _ -ton r <br /> thone No LL <br /> Phone No = <br /> !" J <br /> �- == L 1 7 Il 4 l - <br /> 3F! Waste Code =j Containers Type <br /> Description of Waste Quanta Units No nB <br /> D - Drum � <br /> ElC - Carton <br /> m Bag <br />' T Truck <br /> L—D-1 F� m 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, 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 far t�ansport ton actor'ing to applicable regulations <br /> aneralor Authorized Agent Name Signature Shipment Date <br /> • <br />�uck No Phone No - ' ` F„' <br /> ransporter Name - - - - Driver Name (Punt) �wicd 1 _4����-���,. <br /> j �{� I"t�� r�7r` �t r r=?C <br />[dress Vehicle License No/State <br /> &�l t-� f i -� Id <br /> Vehicle Certification <br /> lereby certify that the above named material wasicked u <br /> p p 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 /> river Sig t re ip ;De <br /> nv slivery Data <br /> DESTINATION <br />� <br /> Vasco Road Sar, ar�� <br /> �J Landfill e Name Phone No I ij 4 4 1 7 Ij 1 9 l <br /> ddress 400 ' Vqszc Fl:�a i .fc­, ,,Rr e , (,a 1 �� J <br /> lereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> i <br /> Authpnzed A en! Si nature Rece+pt pale <br /> PASS CODE <br /> 6 <br /> SH260 720 <br /> GENERATODR RETAIN <br />