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' _� �AV�V— -- ---x?FT -11rr r r� ! �C30A'� = -- No g0605Q <br /> Systems TM - <br />'BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> 1 r1lo Cal Leasinc € 645 E Channel St _ <br /> 'Generator Name Generating Location <br />'Address P C Do, 55103 Address Stockton , Ca <br /> ji rlrt Or _ r n 9 205 <br />'Phone No 5 - ` 6 a 9 Phone No - <br /> BFI Waste Code 4 0 5 LJA 1 $ 9 7 4 3 Containers Type <br /> Description of Waste Quantity Units No Type 0 - Drum <br /> n� C - Carton <br /> Diesel Soil L 1. 8 l _� T B - Bag <br /> T -Tru <br /> P - Poun <br /> ds <br /> Y - Yards <br /> El 1:1O- 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 for--t`a nsportation-according to applicable regulations <br /> ald r' R7r)ehart `' _ # <br /> If enerator Authorized Agent Name Signature Shipment Date <br /> truck No Phone No ' 6 5 '6- �' 16 <br /> Transporter Name M P Environmental Services Driver Name (Print) <br /> iddress- 0 0 'wta s�°r' ' i eA t Vehicle License No /State �G �'` C' <br /> �l, W ;f <br /> Vehicle Certification <br /> 1 <br /> hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the generator site listed above out incident to the destination listed below <br /> lQ y Z Z z' <br /> aver Sig u Shipment Date river S'gfSature Delivery Dale <br /> lam <br /> Pc+�d Sani *_ar�7 Landf4 l l , n— -i �' <br /> Ite Name Phone Nc , <br /> LI <br /> ddress :1'11 Vas_c Road , L-iVerr,ore- , Ca - 94550 <br /> hereby certify that the above named material has been accepted and to the best of my Knowledge the foregoing is true and accurate <br /> EEL= <br /> f Authorized A ent Signature Receipt Date <br /> ASS CODE <br /> 186 8F1260 720 <br /> GENERATOR RETAIN <br />