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F Waste <br /> p9c1_ G � 06028 <br /> SystemsTM <br /> INDUSTRIES ;1ON-HAZARDOUSSPwECIAL WASTE MANIFEST <br /> _ <br /> - <br /> rt �'a'1 (~�a- - �7a t`P,r r4 E (.11c:rlrlE1 ;ti <br /> Generator Name Generating Location <br /> Fdress <br /> O 80- 55102 Address Stockton Ca _ <br /> r� <br /> hone No _ T 7_1 Phone No �— <br /> r <br /> 19 Waste Waste Code 4 0 to � C - 7 � Containers Type <br /> Description of Waste Quantity Units No T pe D - Drum <br /> C - Carton <br /> r i =� i t —tY �iislCtrri fir , ? ❑ <br /> 8 Bag <br /> T Truck <br /> ❑ ❑ P - Pounds <br /> Y Yards <br /> ❑ m ❑ O 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 transportationccordingt to applicable regulations <br /> enerator Authorized Agent Name 5y Signature Shipment Date <br /> ruck No Phone No a 1 r A F P -9 3 15 <br />(ansporter Name Driver Name Print 1 � <br /> 3 .00 Mia r3�,r, Srr,�-�C <br /> dress Vehicle License No/State <br /> Vehicle Certification <br /> ereby certify that the above named material was picked up f 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 /> aver Signature Shipment Oate Driver Signature Delivery Date <br /> r f ! <br /> 1 k tyxt r.� p O y r <br /> v'as�.� F,oao SanitBr�y l_ardf` 11 <br /> # 0l— <br /> e Name Phone No EJ <br /> ddress °ao i ria-� , +�� 9355 <br /> 1 <br /> ereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true-arid accurate <br /> ::0 <br /> Aulhonzed A ent SI nature Receipt Date <br /> r <br /> PASS CODE <br /> ° 8F1260 720 <br /> GENERAT7R DC-T%1114 <br />