ARCHIVED REPORTS XR0001497 - Laserfiche WebLink

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• 3 0 7— e�= > ,.��t t„_, ,��;,,, � 9 X037-Systems 7� NON-HAZARDOUS SPECIAL WASTE MANIFEST 11,M ' ROWI�ING-FERRIS INDUSTRIES GENERATOR - i ca_a�'I r �. N i ofi 9 £ Ch- r�1 �} F ienerator Name fit '6,, `�p � Generating Location ' IJ+ddress P C Box 55103 Address Stockton , Ca =i5_ C1 hone No F Phone No -_- FI Waste Code 0 5 g 9 - ° Containers Type + Description of Waste Quantity Units No Type D Crum mC Carton te-;l S B - Bag T Truck r i � I I � ❑ P Pounds Y Yards 3 ❑ D O Other ! I hereby certify that the above named material does not contain free liquid as defined by 40 CFR hart 260 10 or any applicable state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, classified and packaged, and is in proper condition fortransportationaccordtng to applicable regulations i Ponald 1-. Rirlef)arr - ator Authorized Agent Name Signature Shipment Date • ruck No Z� �� 9 Phone No 16 8 ' t ransporter Name fit L,- • rcmm �* 1 `ter � , Driver Name (Print) �L7 ,� � �.1i, ] +islar�r?r �t^��et:s ddress Vehicle License No/State B 1- =r s f I z d t o —9 -130”, Vehicle Certification n ereb certify that the above named material was picked u I hereby certify that the above named material was delivered with- Y Y P P Y Y t'the'generator site listed above out incident to the destination listed below zj Iver Sign atur Shipment Date Driver S+gnatu r Delivery Date i DESTINATION e Name Vr _co Road Sanitary Landfill Phone No '1 _' 7 0 14 k ddress 4 Vasco Road L.-tvermore Ca �ereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate r e of Authorized A ent Sign alure Aeceipl Date - r � ' 1 , PASS CODE 6 BF1260 72o GENERATGP