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Waste -- �-�F r Acct - No s 00 ` -'No-9 0 6 a-3 Q�- <br /> ISystems T" NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> RGWNING-FERRIS INDUSTRIES <br /> GENERATOR <br /> Mid Cal 1uP8ci•,� yud7 E -F;1i,ll�i <br /> generator Name Generating Location <br /> i P 0 fox 5510? Stockton , Ca <br /> \ddress Address Y - <br /> t 7t I =C+ 3 C <br /> r - <br /> 'hone No r Phone No <br /> ' 1, d r 1 11 I 21 i 7 - Containers TYPE <br /> IAFI Waste Cade 0 - Drum <br /> Description of Waste Quandt Units No Type <br /> F- 1 I I ❑ m C Carton <br /> - _ � �{ rWriil — c —_z3 ,1 I s g Bag <br /> T Truck <br /> ' El � P Pounds <br /> Y Yards <br /> El- - E L1 1 O Other 1- <br /> 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 CFA Part 261 or any applicable state law, has been properly described, 't <br /> classified and packaged, and Is in proper condition for transportation according to applicable regulations <br /> t=ona1d K Rinehart <br /> re ator Authorized Agent Name Signature Shipment Date <br /> ruck No �7 �!t Phone No - <br /> f° P Env- re{-,-ei-t- 3e- n <br /> ansporter Name - ` Driver Name (Print) 6k 1— !__. x)2-1 LL,�-� <br /> 0 fel 3 ri o r 3 t:r e==� - - - - - J_- � -5 � - --- � - <br /> ,ddress' 3 4 0 Vehicle Lic-ense No/State _ -{ � )6vZ E C {4 <br /> E1aL fIalcf C a 9- 0� <br /> Vehicle Certification <br /> hereby 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 atiovz ou incident to the destination listed below <br /> river Signature Shipment Date Driver Signature Dehvery Date <br /> DESTINATION <br /> Vasco Road Sanitary Landifil W t 0 — 4 1 4 7 4D I i <br /> 111,e Name Phone No <br /> ddress `raF2v :0 !iverr-,c,ra , <br />'iereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> e of Authorized Agent Signature Receir,Daae <br /> PASS CODE <br /> 6 � <br /> 6FItFp 720 <br /> �_ENERATOR RETAIN <br />