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PWaste 3F' Acct +;v � 'y G_ ` No 91-1 J V Z 6 <br /> Systems T>w NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> FERRIS INDUSTRIES <br /> • <br /> sM-C. <br /> 3enerator Name Generating Location <br /> C3 Box 55103 Stockton , Ca <br /> Iddress Address <br />''hone No � Phone No _ F <br /> 771 ~' Containers Type <br /> Fl Waste Code <br /> � <br /> Description of Waste Quantit Units No Type D - Drum <br /> ❑ [ iT•J C - Carton <br /> B Bag <br />' ❑ W ❑ T Truck <br /> P - Pounds <br /> Y - Yards <br /> ❑ m ❑ 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 /> stale 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 /> a' ' r F'lnesart <br /> v � _ <br /> e rator Author zed Agent Name &gnalure Shipment Date <br />'ruck No Phone No <br /> ansparter Name Driver Name (Print) <br /> � 1i_r sl3tlsDr �" a� � �Vs` `' <br /> address Vehicle License No (State <br /> Vehicle Certification L/ <br /> kereby certify that the above named material was picked up i hereby certify that the above named material al was delivered with <br /> - <br /> thethe <br /> generator site listed above out incident to the destination listed below <br /> p <br /> river tgnaiure Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br />� <br /> e Name <br /> 4`a PQad Sana tary Land f71I Phone No (1 _ _ A 7 10 1 <br /> address <br />�ereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> I of AuftnzedA eni 5i nature Receipt Oata <br /> PASS CODE <br /> � 8Ff260 720 <br />