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Waste No <br /> Sytems TM <br /> s <br /> ROWNfNG-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> br <br /> it <br /> -M-1c,4 Cal Lensing tr - _ _ 1649 _E Channel Sr z <br /> 3eneratar Name Generating Location <br /> ddress F ,_, - Box 55102 Address Stockton Ca <br /> 4 121 <br /> --3 6 0 --. <br />�hone No Phone No <br /> 3FI Waste Code <br /> 1 0 9 1 1 3 1 ' 1 1 3 1 7 1 5 Containers Type Description of Waste Quandt Units No Type D- Drum <br /> - Carton <br /> r)iv=_el Contamnnated B - Bag <br />' T - Truck <br /> ❑ W ❑ P - Pounds <br /> Y - Yards <br /> „- v �` � ❑ m ❑ 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 transportation according to applicable regulations <br /> C,, <br /> enerator Authorized Agent Name Signature Shipment Date <br /> ruck No —__.(_. 7— __ Phone No a 1 a a S 1-S 3 <br /> N1P Env l r n n fTl- <br /> rl t t i:f�} ��''- i <br /> transporter Name Driver Name (Print) X-_ <br /> I00ddress 24 <br /> t4"�p r t r e 'y_ _ _ _ - , - Vehicle License No /State4,5- <br /> Vehicle <br /> z G <br /> 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 />�t the generator Site listed above out incident to the destination listed below <br /> 1 <br /> Shipment Date Driv�na F-d !' �C L Delivery Date <br /> DESTINAtION <br />'Iddress <br /> eName r,��! _ r', �—Ll <br /> 7 , <br /> Phone No ; <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 /> t t LL I <br /> f Authorized A enl SI nature Receipt Date <br /> PASS CODE <br />�86 BF1260 720 <br /> v GENERATOR RETAIN <br />