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R <br /> x 3 <br /> -*'WaSte___ =R F T_ No- 10 0 9 0 No _9 0�6 0-3- <br /> /StetTM <br /> ROWNlNG-FERE;S lNdUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> ES 1 <br /> ' ld `r�1 1 0r�S1ri�, Y <br /> generator NaM <br /> m{= Generating Location <br /> F '�ddress Box 55103 Address Stockton Cry <br /> a y I I I - <br /> hone Na - - - Phone No T <br /> - 1 5 Containers Type <br /> ,Fl Waste Code D - Drum <br /> Description of Waste Quantity Units No Type <br /> C Carton , <br /> 8 - Bag <br /> T - Truck <br /> I <br /> ❑ m ❑ P - Pounds <br /> Y - Yards <br /> v <br /> � i LID m El <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 for transportation according to applicable regulations <br /> K Fri �ehart <br /> naratOr Authorized Agent Name Signature Shipment Dale <br /> e <br /> luck No -- 1 r F� _., Phone No <br /> ransporter Name h' r F_i v- c ' 1 5=r ` -i c e= Driver Name (Print) <br /> 1 , <br /> dress - 1`1,0 ��'„�" -'r r,-c r Vehicle License No/State ` <br /> 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 Signature Shipment Date Dri er Signature Delivery Date <br /> DESTINATION <br /> e Name Road Sanitary Ilandti ] PhonefNo 0 — 4 - 1 f3 - t <br /> ddress 400 , Vasco Road Liver-i-ore , Ca . 94550, <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 /> EIJ:I= <br /> Authorized A ent Si nature Receipt Date <br /> PASS CODE <br /> ° BFt250 720 <br /> e <br /> a <br /> GENERATOR RETAIN <br />