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3 l <br /> f <br /> U' Systems <br /> TM <br /> 11OWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> - Mid Cal _Leasing y - s - 1649 E Channel St ' <br /> Wenerator Name Generating Location <br /> P- O. Box 55103 _ Stockton Cat - p <br />'ddress " Address ry <br /> Stockton Ca -95205 <br /> i <br /> k <br /> 1 hone No F Phone No <br /> ✓ S 9 2 4 ' Containers Type <br /> FI Waste Code <br /> � � <br /> Description of Waste Quant D - Drum <br /> t Units No 7 pe <br /> ElIn <br /> Diesel Contarninated C - Carton <br /> Sail 1 B - Bag <br /> T Truck <br /> P - Pounds <br /> Y - Yards 4 <br /> FT� E mF] O Other �P <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 properoc nd+tion for`#r ansportatr n,accord,ng to applicable regulations <br /> 7r� 37r� f' R-fne�)arr 1L <br /> neralor Authorized Agent Name Signature Shipment Dale <br /> ' b <br /> ck No Phone No j` -D' 1 5 <br /> ransporter Name <br /> M P Envi ranmenta l Se^vii _e� <br /> Driver Name (Pant) <br /> 3400 Manor <br />[dress '' '� - _ Vehicle License No(State �' e <br /> Vehicle Certification G� <br /> lereby certify that the above named material was picked up I hereby certify that the above named material wa`s delivered with- <br /> t the generator site listed above out incident to the destination listed below <br /> 1, d.. e- <br /> -- K K 9 <br /> aver Signalu Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> Vasco Road Sanirars, Lardfil 1 <br /> e Name Phone No �` Y <br /> T T- c-t , I <br /> '1001 Vasco Rn-_L' <br /> ddress <br />�reby certify that4he above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> F , <br /> Aulhorized <br /> -Ag. - <br /> nt Si nature Receipt Date <br /> PASS CODE <br /> 8 BFI260 720 <br /> GENERATOR RETAIN <br />