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- No.s o 6, 4T53 _ <br /> Systems TM <br /> 131-'ROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST... <br /> 4 <br /> 4 <br /> eneratorName Mid, Cal Les-ino - 1649 F__ Channel= St . <br /> Generating Location <br /> ddress G sox 55103 Address Stockton , Ca <br /> �. ., - <br /> 'hone NoPhone No-- <br /> 'll <br /> o �W f <br /> , <br /> C 5S 0 4 9 2 3 el 9 5 Containers Type <br /> FI Waste Code � f�1_LJ D - Drum <br /> Description of Waste Quanta Units No �T ] <br /> pe <br /> C - Carton <br /> Diesel Contaminated Soil s g m BSag <br /> T - Truck <br /> E= ❑ m ❑ P - Pounds <br /> Y - Yards <br /> E <br /> m El O-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 transportatio according to applicable regulations i <br /> } 4 <br /> r�ot5a1d K . F1r.ahar^t <br /> generator Authorized Agent Name Signature j Shipment Date <br /> 0 <br /> r <br />'ruck No Phone No 9 1 a -J68-93 . 6 <br /> ransporter Name M P Environmental Services Driver Name (Print) <br /> ddress" 1400 M_9r-ior, Stre9t_ - - Vehicle L I icense'No/State 7 <br /> 9LF- <br /> Vehicle Certification <br /> hereby certify that the above named,material was picked upI hereby certify that the above named material was delivered with- <br /> at the generator site listed above out incident to the destination listed below <br /> Driver Signatu Shipment Date Driver Signator Delivery Date <br /> !I • <br /> ite Namer _ ni ` Lardf� , � _ - <br /> Phone No 1 — + � <br /> , <br /> „ <br /> 1ddress 4007 Vas � �-_ �er�m�rc C� _ ,., 550 <br /> ' f <br /> ereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> :, <br /> t Authonze�Ant <br /> Si nature Rece�ot Date <br /> PASS CODE P <br /> 186 BF1260 720 <br /> GENERATOR RETAIN \ <br />