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1 <br /> Wash t3F 1 Acct No 100904? Na <br /> 1 -_ �-Q4-m-� �_--_-_- - __- --r--- -- -- -- -- = _ -- s 9-07 9=7=5= <br /> - Sj/Ste■ ■ �s TM <br /> rROWNING-FERRIS11joUSTRIES'^ NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> M "Cail leasing r _ 1649 E . Channel - St = - <br /> enerator Name Generating Location <br /> ddress 4. Bax 55103 Address Stockton , Ca N <br /> Stockton , Ca . , 95205 <br /> 0 <br />'hone No '=-14 - - Phone No <br /> 0 9 1 1 f 2 3 7 5 Containers Type <br /> 3F1 Waste Code - <br /> Description of Waste Quantity Units No Type D - Drum <br /> Diesel Contaminated So i 1 18 �t m T C -Carton <br /> B - Bag _ <br />' T -Truck <br /> F] ❑ <br /> P - Pounds <br /> Y - Yards <br /> 0-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 /> I classified and packaged, and is in proper condition for transportation ccordln to applicable regulations <br /> I <br /> �onL� 1d Rinehart <br /> nerator Authorized Agent Name Signature Shipment Date <br /> TRANS s <br /> luck No _ 4009 009 Phone No 9 1 6 6 6 5-4 3 1 6 <br /> ransporter Name <br /> Al P Environmental Services �U <br /> Driver Name (Print) i <br /> 3400 Manor Street <, <br /> C� + <br /> dress - - - Vehicle License No/State- r- <br /> Ea� ar�f7eld <br /> r <br /> Vehicle Certification <br /> lereby certify that the above named material was picked up d hereby certify that the above named material was delivered with- <br /> t the generator site listed above) out incident to the destination listed below <br /> rivet Signature ShipWent Date Drive rgnature Delivery Date — <br /> DESTINATION <br /> Vasco RoadSanitary Landfill � n = � <br /> e Name v Phone No I t <br /> 4007 Vasco Road Livermore , Ca 94550 <br /> dress <br />�reby certify that the above named material has been accepted and to the best of my knowledge the foren.,ing is true and accurate <br /> _ r <br /> uthonzed A ent Sr nature Receipt Date <br /> i <br /> PASS CODE <br /> 6 6F1260 720 <br /> S, <br /> GENERATOR RETAIN <br />