Laserfiche WebLink
P�ROWNING-IFERRIS <br /> WastNo 9 47 9.7 9= �- -_- <br /> Systems TM <br /> INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> . � <br /> Mid C--" Le ,—in 1649 6 _ Chanr),E-_j .St . <br /> eneratar Name - - Generating Location <br /> P C sox 55103 Stockton , Ca ' <br /> Iddress �" ° r Address <br /> �crkt-on ra g5^0` M <br />'hone NoPhone No <br /> 9 1 1 21 1 3 7 S Containers Type k <br /> 3FI Waste Code 1 1 D - Drum <br /> Description of Waste ' Quandty Units No Type <br /> " Die c-el Gon'�arnir`aL&d wG t , 1 ? I T B - Bagon <br /> T - Truck <br /> ❑ m ❑ P - Pounds <br /> a Y - Yards <br /> 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 /> neralor Authorized Agent Name Signature Shipment Date <br /> TRANSPO <br /> 3 ` h � <br /> luck No Phone No 3- 316 <br /> M P Env-ironm�nt,e� Serv-1`_- <br /> ranspor#er Name Drover Name (Print) <br /> Man— I <br /> L <br /> dress 4 - �� - - - - - Vehicle License No/State ;z=•�_ C �- <br /> Vehicle Certification <br /> tereby 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 /> id 5 gnature shrpment Date- Af Signature Delivery Date <br /> 4 Sl 1 1 <br /> DESTINATION <br /> 1 <br />�te Name ,Phone No <br />,ddress <br /> lereby certify that the above named material has been accepted and to the best of rhv knowledge the foregoing is true and accurate <br /> 1 <br /> 1 1 + 1 <br /> Authorizer,Agent Signature Receipt Date <br /> r <br /> PASS CODE <br /> I86 + 6F1260 720 <br /> GENERATOR RETAIL <br />