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I-Waste- ­ -,-No'P-So 6 03 <br /> ystems 1 <br /> 3ROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Mid Cal 164 ; L . CIiQr r,e t <br />'venerator Name Generating Location <br />(,Address P 0' 80'< 5510- Address <br /> J Stockton , Ca <br /> 11 <br /> c. a_ZI`torl C i 7�'�� <br /> Ij - i��~ ...- ..�. 4 -• Y } •Phone Nor <br /> hone No ELI � J <br /> 3Fl Waste Cade `i i 3 - Containers Type <br /> Description of Waste Quantit Units No Type D - Drum <br /> - C - Carton <br /> _cri, Z _mac' �, _ El m � B Bag <br /> ❑ T - Truck <br /> nP - Pounds � <br /> LYY ardsElther " <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 fransporta an according to applicable regulations � <br /> Qonald h _ Rinehat,t � <br />,e for Authorized Agent Name Signa ure Shipment Date <br /> • <br />}ruck No � l r u 16 15 `- � ' �3 l = <br /> Phone No <br /> Iransporter Name Driver Name (Print) <br /> ddress ?400 -rola nor 'r r,e o t r � Vehicle License No !State � �T��' � ' -_ __ _ __V <br /> —r .. <br /> 9=3 0 4 Vehicle Certification <br /> L � <br />�ereby certify that the above named mater I was picked up I hereby certify that the above named material was delivered with- <br /> t,,the generator site listed above o>;t mcid r1t to the destination listed b ow <br /> S+ n Shipment Date Driver ignalure Delivery Date <br /> • • <br /> e Name Vasco Road Sabi tary. Land i l l Phone No 1 ` I 01 - 0 <br /> ddress " C'0 Ufa ca foaFa L� -errzc,re , La g4S50' ' <br /> ereby certify that the above named material has been accepted and to the'best of my knowledge the foregoing is true and accurate i <br /> e of Authorized A ent Si nature W Receipt Date <br /> ' ` d <br /> PASS CODE <br /> BF1260 72v <br /> GENERATOR RETAIN <br />