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r ' <br /> WSystemslrA <br /> LFI Acrt "o_ 1009042 <br /> NON_-HAZARDOUS <br /> BROWNING-FERRIS INDUSTRIES SPE ClAL WASTE <br /> MANIFEST <br /> Sam <br /> �eneratof Name Cal t -as-.r,- - J 1 ~4 � E Ctianrt <br /> ie i � <br /> Generating Location <br /> Iddress P C ' 130-K 5510` Address Stockton , Ca . <br /> c r <br /> CC k"t-or' C n 5 2 C,5 <br />[hone �— c o f No !F Phone No <br /> FI Waste Cade <br /> P u Q 1 3 f Containers Type <br /> Description of Waste Quantity Units No Type D Drum <br /> 3 ❑ m C Carton <br /> ❑ <br /> L C Bag <br /> ❑ ❑ T -Truck <br /> P - Pounds <br /> Y Yards <br /> El ❑ O Other <br /> 1 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 fransporta on accordinl ill applicable regulations <br /> Ronald K _ Rineharr_ <br /> Ina <br /> rtor Authorized Agent Name Signature Shipment Date <br /> ­ao�4y�id3�' ff �e4 � -4 ` 0 °FSS "Moll d, a a >u �n rti�..r- 'o y9 �&,r �^ <br /> t' a� a e a <br /> uck No f r Phone No <br /> Name <br /> rans orter M Env i ronmentaI services <br /> Driver Name (Print) .� ��� <br /> p ` /.__ Z S � <br />[dress 4D0 Manor <br /> Vehicle License No/State 5 <br /> G t,e �rfi e l d C a 9,2308 Vehicle Certification <br /> ereby certify that the above named mater I was picked up I hereby certify that the above named material was delivered with- <br /> the <br /> ith- <br /> thegnrater site listed above out incid tit to the destination listed b ow <br /> r <br /> Si�rnaftl Shipment Date Driver tgnature Delivery Date <br /> rp <br /> eName Vasco Read Sanitary Landfill Phone No t.J1-1 <br /> 4 - � <br /> dress " ` 0 !`rico I`oaa _ L-iyermor e, Ca 94550 ! <br /> 4 <br /> ereby certify that the above named material has been accepted and to the best of my knowledge the foregoing Is true and accurate <br /> EIT= <br /> _f Authorized Agent Signature Rece;pt Date <br /> i <br /> � I <br /> PASS CODE <br /> SF1260 720 <br /> GENERATOR RETAIN <br />