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No 9 0 6 0 31. - -- <br /> ! S' 3�I ,�ccC _ No_ 1003G�t <br /> /StetTM <br /> iROWNING FERC; S INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> ES <br /> Ir ti ` <br /> M_ic? _ ? 3 easinci 1649 Erail ,'mel �� <br /> generator Nam, Generating Location <br /> Iddress P So,( 55103 Address Stockton , C8 <br /> rlt 11 95205 <br /> i <br /> 'hone No � I d 5 1 Phone No <br /> t3 <br /> FI Waste Cade 0 9 i?1 It <br /> ^c 3 ' 4 S Containers Type <br /> Description of Waste Quantity Units No Type D Drum <br /> Eln '� C Carton <br /> L J� D B - Bag <br />' T - Truck <br /> F—] ❑ P - Pounds <br /> J Y - Yards <br /> ❑ -� ❑ O- Other <br /> l 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 /> �rna� n R-i )ehart `- <br /> �nemlor Aulhonzed Agent Name Signature Shipment Date <br /> '?; � ,�§ ,P'` Wf us a�x ' 6 ' " ' c " •k'at,s�+�+y� .w '�rc, <br /> a :r <br /> uck No C, `" 1 Phone No ' �' 5 8-°3 1 6 <br /> ransporter Name ` PYtw rcr'ri=',t" Dery I cpC Driver Name (Print) <br />[dress X400 Llano- 5rr eet <br /> pp C Vehicle License No(State <br /> Vehicle Certification <br /> ereby certsfy that the above named material was picked up I hereby certify that the above named material was delivered with- <br />�t the generator site listed above out incident to the destination fisted below <br /> river S�gnalure Shipment Date Dritrer Signature Delivery Date <br /> ggld <br /> , <br /> e Name Vasco Roaa Sanitary tar^y Landf-i i 1 Phone Na _ t 0 — 4 4 7 0 <br /> ddress <br /> -ODI `'asc,o Road Livermore , Ca 94550 <br /> lereby certify that the above named material has been accepted and to the best of my knowledge the foregoing Is true and accurate <br /> EJ: <br /> Authorized Agent St nature Receipt Dale <br /> PASS CODE <br /> ° SFt2no 720 <br /> GENERATOR RETAIN <br />