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T <br /> 1 _SaWaste __ 8F1 Acct No 1009042 No 9Q <br /> y%.v TM <br />;ROWNING-IFERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> Mid Cal t_e:scInci a 1619 E . Chaonal St <br /> enerator"Name Generating Location <br /> P 0 soh 55103 Stockton , Ga " <br />�ddress Address <br /> i <br /> Stockton Ca 95205 <br /> Ihone No _ " Phone No <br /> iContainers Type <br /> 3Fl Waste'Code , _ D Drum <br /> Description of Waste Quantity <br /> 3 UnC - Carton <br /> Units <br /> I Diesel Ccntarhinatec� So, 1 <br /> 8 - Bag <br />' m ❑ T - Truck <br /> F-1 , <br /> P Pounds <br /> Y - Yards <br /> - - ❑ m E 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 property described, , <br /> I classified and packaged, and is in proper condition for tr <br /> ansportation according to applicable regulations <br /> {till i•l � r� s\ to ll y'IIG3t � / -1 <br /> - � - <br /> nerator Authorized Agent Name Signature Shipment Date <br /> ITER <br /> luck No ` _ f tD_ �x= - Phone No : <br /> N1 P En%,ironmentaI Senvicesr---- <br /> ransporter Name Driver Name (Print) <br />[ "- - <br /> 4 G 0P�1at7o#' `r l =o t~dress - <br /> - - W - Vehicle License No/State f f <br /> Vehicle Certification <br /> lereby 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 /> TEI <br /> Iriver Signature - Shipment Date C__Bnver Signature Delivery Date w <br /> DESTINATION <br /> Vasco Poad Sant to-y Landfill T n ' <br /> e Name Phone No FT_ <br /> I k'o I -Vasco} -'Ioa[' Lid errvoi- Ca 94550 <br /> ddress <br />�ereby certify that the above named material has been accepted and to the best of my'knowledge the foregolnc �s true and accurate <br /> F t J= <br /> _ I <br /> tAuthonzed Agent Signature Receipt Date <br /> 7 <br /> PASS CODE <br /> 6 6F1260 720 <br /> GENERATOR RETAN <br />