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111 1 <br /> Waste-- ---- -- _RP v_; -Acct No__ �fla oa2W�- -------- - ---No 906042_�_�_ _ <br /> IN" Sy- stems TM <br /> BROWNING FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> 0 <br /> Generator Name <br /> Mid Cal Leasing Generating Location 1549 E Channel - <br /> St <br /> ddress Address . <br />� <br /> P - U_ Sox 55103 Stockton , Ca - <br /> Stockton , Ca _ 95205 <br /> hone No 0 g 4 3 6 0 P J:j Phone No �T - <br /> G A 4 0 0 9 1{ 8 2 3 774 5 <br /> Containers Type <br /> BFI Waste Code D - Drum <br /> Description of Waste Quantit Units No T pe <br /> C - Carton <br /> Diesel Contaminated Scil 1 8 � m T B - Bag <br /> T -Truck <br /> I 1_7_1 ❑ m ❑ P - Pounds <br /> Y - Yards <br /> Elm El - 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 foC lrysportatio according to applicable regulations <br /> Generator Authorized Agent Name Signature Shipment Date <br /> N <br /> ruck No 3960 Phone No <br /> ransporter Name M P Env-i ronrrten to l Services-, Driver Name (Print) <br /> 3 n0 M9nor' Ia <br /> c er <br />�ddress "t Vehicle License No(State <br /> � E es f i e I a 90C <br /> Vehicle Certification <br />[hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> the generator site listed ove out incident to the destination listed below <br /> wigna <br /> SFipment Date Driver Signature Uelivery Date <br /> el <br /> Vern Po?d Sanitai-V Lanlf 11 n _ 0 7 0 1 1 <br /> Site Name Phone No ; <br /> Fdress 4f2'" I rico Rt ad Li mor•r Ca 94550 <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 /> I Authorized Agent - Signature Receipt Date <br /> PASS CODE <br />�86 $i=1260 7 <br /> GENERATOR RETAIN <br />