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f Waste- 9 it Acct _ �� O L�S f3 Y 4 Nt� V O Y O 2 5 Systems TM NON-HAZARDOUS- ' ROWNING-FERRIS INDUSTRIES SPECIAL WASTE MANIFEST F4 lti, 49 P Cha.el ,r ^ -jenerator Name ,enerateng Location Ct address P'ok 55 111 4ddress Stockton , Ca . [hone No Phone No �— s !FIWaste Code L A n J i 9 w I 7 - Containers Type Description of Waste Quantity Units No Type D - Drum ❑ �� ❑ C Carton lca frlicrti `-�01 � ' `� B Bag ' ❑ T - Truck �� ❑ P - Pounds Y Yards EE= ❑ ❑ O Other 1 hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 or any applicable state law, Is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, classified and packaged, and is in proper condition for,transportatlon according to applicable regulations �nerator Authorized Agent Name Signature Shipment Date Fuck No Phone No 3 1 6 F,58-91316 ani Drier Name h� P E'�vI �n�rt r,tr, Ser-v-i ce- P Driver Name (PrinQ `�'4 0( dress 0 r�l`n�r �t�� t Vehicle License No/State— /f� 0 C R 3 21 0 P Vehicle Certification Leby c (fify that the above named material was picked up 1 hereby c 7 tify that the a eve named material was delivered with- t the g er/ator site lise above out inti t to the de enation listed below river Signature Shipment Date Driver Signature Delivery Date W MA MM Im e Name `r uco Rcad 33arn ;to ry L anc.l i 4, 1 1 Phone No �— 41 ? I; ._, f I`, < ddress 4 0 v a s c c it za- Live^ torte Ce, 9 55Cf ereby certify that the above namea material has been accepted and to the best of my knowledge the foregoing is true and accurate I I PtZAAuthorized A ent Signature Receipt Date E i i i PASS CODE; i 35 BFI260 720 u"-%ERATOR RETAIN