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• <br /> x - aste`___= - 9 o s-to=4-0�__��� <br /> � ��: i�CCt ''t0_�1QOS' <br /> TM <br /> Systems N,ON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> >ROWNiNG-FERRIS INDUSTRIES <br /> GENERATOR <br /> Mid- Cal Uelsir+a J -- 1 1649 fY - -Channel 5t <br /> generator Name Generating '-ocation <br /> t P. O. Box 55103 Stockton , Ca - <br /> I +ddress Address <br /> ^ � r <br /> StorLltorj . Ca 75205 <br /> F <br /> 'hone No y v — 3 E Phone No <br /> G 4 0 9 1 P 1 2 1 3 7 5 Containers Type <br /> FI Waste Code I I17 - Drum <br /> ' Description of Waste Quantit Units No Type <br /> mG -Garton <br /> l <br /> Di es �l CGn;crr,�r�ted Scr- 1_ I� T❑ B Bag <br /> E <br /> { -� T Truck a F-1W ❑ P Pounds ` <br /> Y Yards <br /> Elm 1:1O 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 trap port tion ccordin to applicable regulations <br /> Ronald K- Rinehart r i � ( <br /> for Authorized Agent Name Signature Shipment Date <br /> TRANSP96 <br /> Phone No ? 1 6 5 6 8-5 3 1 6 <br /> ruck No I 7 <br /> t <br /> ransporter Name M P Envi -onfn ntal `e1' i -e=_ Driver Name (Print) 4,1_ <br /> 3400 Manor :street " <br /> ddress Vehicle License No/State 2 S� 7 S�! 7 ` (Y rn 6 S Ap <br /> r <br /> S©ke r s f i e l o' - Ca 93308 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 /> } the generator site listed above out incident to the destination listed below <br /> r1 ,712tij - zt <br /> Wer Signature Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> to Nam .'sco Roar! Sanitary Landoo 1 1 Phone No } O — 4 4 711 <br /> g 1 <br /> ddress 11001 Vasco Roac , Ca :�4 x,50 <br /> lereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> I' - <br /> IlLn <br /> i <br /> e of Authorized Agent Signature Receipt Date <br /> PASS CODE <br /> ia 6 SF1260 720 <br /> C3FN-+=-A-[t 1=r RI=TAIN <br />