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im <br /> waste No906927 <br /> BFi Acct tic 1UJ9042aoSystems TM NON—HAZARDOUS SPECIAL W I <br /> WNING-FERRIS lNgUSTR1ES WASTE MANIFEST <br /> cnerator Name tf i 4�5 r Generating Location <br />�ddress P D Bev 55103 Address Stockton Ca <br /> 952S <br /> hone No ' Phone No ❑� <br /> PI Waste Code 1 9 F 12 1 21 ` 141. Containers Type <br /> - <br /> Description of Waste Quant C <br /> t Units No T pe D - ar o <br /> - Elm B - Carton <br /> r - _ _ - r,� <<_ _ � _�- - - Bag � <br /> _7= T - Truck <br /> ❑ ❑ P - Pounds <br /> Y - Yards <br /> El i I �] ❑ 0 ❑ 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 for transportation-according to applicable regulations <br /> E1 - -7 <br /> n ator Authorized Agent Name Signature Shipment Date <br /> • <br /> luck No Phone No <br /> F E.- \ 1 1 a,t F,!?114 Cn I �C--„Y - - � } l`1a\ <br /> nsporter Name Driver Name (Print) j rin 1 <br /> dress Vehicle License No/State <br /> Vehicle Certification <br />-iereby certify that the above named material was picked up l hereby certify that the above named material was delivered with- <br />,the_�enerator site listed above out incident to the destination listed below <br /> 1 <br /> Iver Signature Shipment Date Drrver`5ignature Delivery Date <br /> DESTINATION <br /> Name Vasco Road Sani tart' Landfill Phone No =—F—T41 7 1 0 1 <br /> idress 011 \16scc= koaa - Li verrnore C& 94 550 <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 /> P.WZAu�thorizedA Bent Signature Recent Date <br /> PASS CODE _ <br /> o BF1260 720 <br /> GEINFRATOP FFT4u"IN <br />