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�;A90WNING-IFERRIS <br /> R Waste _ __ _ _� _ _ _- __ _____ __ _ _ <br /> BFI Acct= No. 1 (�a9042 —No 906027 <br /> Systems TM NON-HAZARD <br /> INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> 0 <br /> 11! Bill 11111" <br /> I, lJ C I ea5�n� 1649 E~ Cl- at~nel <br /> enerator Name T Generating Location M <br /> Iddress <br /> P - 0 Be - 55103 Address Stockton , Ca <br /> 952105 <br /> 1hone'No - 6 �� <br /> Phone No <br /> FI Waste Code 91 <br /> 4' 5 -110 2 ' 4 Containers Type <br />' Description of Waste Quantity Units No Type D Drum <br /> El <br /> F-11B - Carton <br /> B - Bag <br />' ❑ ❑ T - Truck <br /> P Pounds <br /> Y - Yards <br />' ❑ � F-10- 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 /> / t <br /> f-ConaId IN R- nehart ice-` C� - <br /> nerator Authorized Agent Name Signature Shipment Date <br /> s <br /> uck No ���1 Phone No 16 <br /> �i \ 0,-) a I Se- r l C-_ <br />(ansporter Name Driver Name (Print) �tn'1 1� 1,Q IM LA <br /> dress d`t 0 '' t `t rre' Vehicle License No /State <br /> Enai e^s ` eI r . 93 i0 Ell <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 th"enerator site listed above out ipcident to the destination listed below <br /> 0 c1 �. � L � <br /> Ever Signature Shipment Date Driver Egnature Delivery Date <br /> � I <br /> eNameVaSC0 Road Sanitary Landfill 0 — 4 7 0 1 <br /> Phone No <br /> I I <br />-!dress 4 u0 E Y ascc; Road . L i vermore Ce 44 550 <br /> reby certify that the above named material has been accepted and to the best of my knowledge the foregoing Is true and accurate <br /> i <br /> ft_Au�lhorizedA ent Signature Rec©Epi Date <br /> PASS CODE <br />�b BFf260 720 <br /> GENERATOR r-F-TAIN <br />