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? r <br /> t - <br /> W�ste x <br /> a_— - - -r T • ��� 4 � -�__ _ —NO� 9 0?9 8 <br /> TM: SYSteES <br /> ROWNINGFERRIS INDUSTRIES <br /> NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> ESw�T3 , Y' f � r <br /> i Mid Cal Le-,vs i n- " 649 F Channel St - <br /> :1enerator Name Generating Location <br /> ddress n Eifl>� 55103 Stocktc,r Ca <br /> -^ Address - , <br /> 5 i <br /> = Y =0 S 4 <br /> hone No — � Phone No �— y <br /> C A �4 t1 •, 0 3 1 8 2 r 'f 5 Containers Type <br /> F! Waste Code L� <br /> Description of Waste Quantity Units No T pe D - Drum <br /> C - Carton <br /> CC)ntkt' i nated So, - m B - Bag <br /> ❑ T - Truck <br /> I = F-1 <br /> P - Pounds <br /> Y - Yards <br /> El 1:1 D O- Other_1 , <br /> 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 transports ion according to applicable regulations <br /> i ' <br /> nerator Authorized Agent Name Signature Shipment pate <br /> 8 <br /> luck No Phone No 0 i "6 3-9 3 1 6 <br /> �r"`vi ,,>s-�rn�n*n`i � ^v-i �-mss <br /> ransporter Name int p Driver Name (Print) FS,_ 41(f _ <br />[dress - u - Vehicle License No/State <br /> Vehicle Certification <br /> lereby certify that the above named material wasicked u <br /> p p 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 />!iv4Si �urerShipment��_rrv6r ig ature Delivery Date <br /> D.ESTINATWN <br />�e Name ; ' `�- - - � � - ��', �, Phone No <br /> ddress c_ L c = i - r S.a <br /> 16reby certify that the above nanied material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> Authored A ent Si nature Receipt Date <br /> PASS CODE <br /> G <br /> BFI260 720 <br /> GENERATOR RETAIN <br />