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Waste w_ _ _ Or- � _Acct_�.No_ _410o9.Oa2 No 10 Systems 7M 'BROWNING FERRIS INDUSTRIES NON-HAZARDOUSNI SPECIAL WASTE MANIFEST A M1UJ NOME=- Mid Cbl Leasinn _ 1649 E Channal St . Generator Name- _ Generating Location~ P GS Sow 55103 Stockton, , Ca Address Address 1 r SrocktQn . Ca . 352r?5 — 4 Fone_NAT_4 3 Phone No �^ BFI Waste Code _cFA4 0 9 1 8 2 7 4 5 Containers Type tJ - Drum Description of Waste Quantity Units No T pe C -Carton iesl ContaminntPd CCl7 B Bag T - Truck ❑ E� 1 ❑ P - Pounds � Y - Yards El O- Other , - I 1_ I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 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 fob transporiatlon.according to applicable regulations - F R; n-#)art r - 1 'enerafor Authorized Agenf Name Signature Shipment Date ruck No � � Phare No 91h E68-93 ' 6 ' Transporter Name M P E n r on r, =n t a S Er v c ss Driver Name (Print) � -inn 'Minor '1tr^ea` �f Iddress,- - -* - - - Vehicle License No/State -� Vehicle Certification hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with at the generator site listed above out incident to the destination listed below Jnv igna ............Date Driver Signature Cehvery Date DESTINATION ate Name Ponad Mani -ai—V i_an,-3 f i l Phone No n ' n t ' �i0 1 `:F-c,—, '�'C car" L i ,�F-I^rr,0r= Ca 9A C'L s Iddress hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate Am - . I I El:]:]= of Authorized Agent Si nature Receipt Date PASS CODE igs ' BF1260 7 GENERATOR RETAIN