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IMF <br /> y C gy{J`nv� <br /> �_ *_4_a Ste_-� -�..._ .�Lr S'_t __D{`_S` -ti�v_— a 009 .12-- _ -__ _—iso 9 07-97-6_ <br /> Systems TM <br /> 7FIOWNING-F�RRES f�tDEJS7RfES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Mid Cal Leasing 1649 E Channel St - <br /> kenerator Name Generating Location <br /> ddress <br /> P . g Sox 55103 Stockton , Ca <br /> Address <br /> ..oSl acs 25205 <br /> 014 <br /> hone No 4 — 5 fl <br /> Phone No <br /> FI Waste Code C A 4 0 t - 0 9 1 8 1 2 11 3 1 7 5 Containers Type <br /> Description of Waste Quantity Units No T pe D- Drum <br /> C - Carton <br /> 0-1 esel Contaminated Soil L I I � 8 � m T B - Bag <br /> T -Truck <br />' ❑ m ❑ P - Pounds <br /> Y -Yards <br /> F-1 El - Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 110 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�transportat on,according to applicable regulations <br /> "c,rla-ld k Rinehhar-t — <br />'enerator Authorized Agent Name Signatu4e Shipment Date <br /> N 4 °mM- <br /> ruck No (:7 cf -7 O_ Phone Na <br /> M P I=nv-ironrr�wntcEl_ ServiceE i <br /> transporter Name Driver Name (Print) <br /> Iddress 2400 Manor, =treca' <br /> Vehicle License No /State 2- Z_ _5 S::::.7— /u %u_._ <br /> tereby <br /> Vehicle Certification <br /> certify that the above named material was picked up I herebycertify that the above named material was delivered wl - <br /> Y th <br />�t the generator site listed above out Incident to the destination listed below <br />[�:2 � .4 z z <br />)river i re Shipment Date Dnvi lgna —n `�' Delivery pale <br /> 0 � 0 <br /> r h ^c'� �!1 i� 7��1� t'�y r >> I_�ri to i"i ? l <br /> to Name Phone No <br /> dress 100 -1 ve scc L- vcr roo C ?-1554 <br /> Iereby certify that the above named material has been accepted and to the best of my knowledge the foregosng is true and accurate <br /> I <br /> f AutAgent Si nature Receipt Date <br /> P �n <br /> PASS CODE <br />�B6 BFI260 720 <br /> G£UERATOR RETAIN <br />