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J Waste— �- —PST—Ac��--{��— , nn�n _ --_----- _ Na Systems906044 -- = --- TPA INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST GENERA IJ mid Cal Leas-i nQ 1649 E . Channel St - Generator Name Generating Location 'Address P 0 Box 55103 Address Stockton Ca Stockton Ca _ SS?_05 2 Q 9 5 3 6 'Phone No ��— _ ._� Phone No - C JA9 1 9 2 I 7 s 5 Containers Type BFI Waste Code I D - Drum Description of Waste Quantity Units No Type C - Carton Diesel Contaminated Soil L I I 1 1 8 � m 0 B - Bag ❑ m ❑ T - u P - Pounds Y - Yards El 1 ❑ m El - Other I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 or any applicable state law, Is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, classified and packaged, and is in proper,corrdition for transportation according'to applicable regulations ti 1, ` Pon-- ld Rinehart Generator Authorized Agent Name Signature Shipment Date 31&' 0 � �i ""r'f1C�:A. •yti p [�-:q y� 'aY a a • Q '{tk` `�`�^ -�"„+•" � ( �9+'-fgr ea`5'w'GY.,i..j ",p Fruck No - ��.3)_ Phone No M P Env-lr-onmental Services ,j �' Transporter Name Driver Name (Print) _,t i1 "400 Manor SYr�eet Iddress Vehicle License No /State Vehicle Certification hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- at the generator site listed above r, out incident to the destination listed below G Driver Signature ' Shipment Date Driver Signature Delivery Date a o � ! Vas= Road Sari r v Lard-Fill ite Name Phone No ddress 001 Vasco RoadP Ca 94550 Ihereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate Y - of Aulhonzed Agent Signature Receipt Dale PASS CD E l 0186 SF1260 720 GENERATOR RETAiN