Laserfiche WebLink
;OSystems TM <br /> FRIOWNING-FERRISNON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> generator Name M ' u Ca) t_Aec l r' Generating Location 1649 C�'` Gt <br /> ddress p C Bo K 5 5 1 0 3 Address S't oc kton , Ca <br /> I <br />'hone No ` `' _ tr' �_❑ L—JT _ _❑❑❑ <br /> Phone No <br /> Fl Waste Code U 5 9 9 S Containers Type <br /> Description of Waste Quantity Units No Type d - Drum <br /> f� C Carlon <br /> r1:3 <br /> �r.nt' r=)� � �tEc1 �ci E W- 6 - Bag <br />' m F-1T Truck <br /> ❑ <br /> P Pounds <br /> Y Yards <br /> ❑ m ❑ 0- Other <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 foritransportation acco ding to applicable regulations <br /> r <br /> J 1 <br /> ii'oro4Id F: _ Rinehart f <br /> nerator Authorized Agent Name Signature Shipment Date <br /> <c k 7 " " ` *s fi�Y • p -..,�' a a���8d3.ra �s-h't�nvk <br /> �`7 <br /> luck No u 9 Phone No 9 1 6 S68-93 ; 6 <br /> ransporter Name P El-,, I r on me r,t a 1 S e r v-i :;G�_ Driver Name (Print) <br />[dress 400 Mas o r' t r"'c Vehicle License No/State <br /> 9 '0 0 Vehicle Certification <br /> lereby certify that the above named material was picked up I herebycertify that the above named material w <br /> Y as delivered with- <br /> t the generator site listed above out incident to the destination listed below <br /> _ 9 Z <br /> Iver Signatur Shipment Date Driver Signatu Delivery Date <br /> Q � <br /> m <br /> Name V-,f Co ROacl ,mann Cary Landfill Phone No I s ' 7 LJ 4 <br /> dress - ' t Vasco Road - L.R venmcre Ca 9A950 <br /> Ireby certify that the above named material has been accepted and to the best of my Knowledge the foregoing is true and accurate <br /> Aulhonzed A ent Si nature Receipt Data <br /> PASS CODE <br /> eF1260 720 <br /> GENERATOR RE rA1:j <br />