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Systems <br /> TM � <br /> OWNING-FERRIS lNDllSTfliES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> -Mid Cal Leasing r _ 1549 E Channel ;t <br /> venerator Name Generating Location <br /> ddress O Bon Address <br /> 55103 Stockton , Ca . <br /> = tor _ Ca Q5205 <br /> s _ <br /> =_I 4 16 _ 3 5 1 U 9 <br /> Rhone No + Phone No <br /> C A Q 0 9 7 1 8 r I j [--3—r 7 4 Containers Type <br /> 11`1 Waste Code D - Drum <br /> Description of Waste Quandt Units No T pe <br /> 8 Elm C Carton <br /> G� ectal Contaminated Soy I B Bag <br /> T Truck <br /> ❑ W ❑ P Pounds <br /> Y Yards <br /> t <br /> - _ - - � _- ❑ m-El O- Other' <br /> J <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 transportatro ccording to applicable regulations <br /> Donald K Rnc)ehart <br /> ator Authorized Agent Name Signaiwe Shipment Date <br /> Or <br /> uck No W Phone No , { 6 6 5 5 W ///t C <br /> idansporter Name h1 ' > Eng ror+menta1 Servscep Driver Name (Print) '�"'/ L�11L�i3 Pf1a��o�_� :3tr �?='� � - err -_ _ ..�dress Vehicle License No /State r <br /> Vehicle Certification <br /> hereby certifyuthat,the above named material was picked up 1 hereby certify that the above named material was delivered w�th- <br /> the enerator,site'isted above out irpcident to.the desl)Aatrorf listed below <br /> 019 a - <br />}rtver Sig ture Shipment Date Driver i nature Delivery Date <br /> DESTINATION <br /> to Name P n al ntmiry Lar.-Jfill _ <br /> 'Phone R <br /> address -`� ' Vt�7scc Road', L-, .err+sera Ca 93 550 <br />�iereby certify that th1 e above named material has been accepted and to the best of r*-, knowledge the foregoing is true and accurate <br /> +t + <br /> Rf Author zed A ent a Si nature Rece of Date <br /> PASS CODE <br /> 196 + <br /> BFt260 720 <br /> GENERATOR RETAIN <br />