Laserfiche WebLink
t t <br />� s <br /> maacte <br /> iloSystems 71N <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • ` <br /> Mid Cal Leasing 1649 E_ Ch,;annel St . <br /> Generator Name Generating Location <br /> P 0_ Sox 55100 Stockton , Ca <br /> ddress Address <br /> Ca 959n5 <br /> 2 0 9 5 3 6 <br /> hone No =9 Phone No �- <br /> C A <br /> FI Waste Code 0 1 8 1 L 9 2 1 3 7 g 5 Containers Type <br /> Description of Waste Quantit Units No Type D - Drum <br /> O�rsel Ca+rtamir, ,tGci Soil 1 8 1 F C -Carton <br /> B - Bag <br /> T -Truck <br /> ❑ ❑ P - Pounds <br /> Y -Yards <br /> ❑ �� ❑ 4- 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 transportatio ccordin to applicable regulations <br /> canal c 1, _ E 1 nehar <br /> enoralor Authorized Agent Name Signature Shipment Date <br /> n V+ <br /> 'g <br /> c "'fib <br /> u <br /> truck No `` Phone No S 1 6 668-9316 <br /> P EnviEnvironmentalmer ✓ ice <br /> r'ransporter Name r Driver Name (Print) )1�11 h__ti n1y)I A <br /> "a L Manor, St r'eet <br /> ddress Vehicle License No /State to I <br /> Vehicle Certification <br /> ereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br />,t the generator site listed above out incident to the destination listed below <br /> Ir , <br /> aver Signature f Shipment Date Driver` ignature Delivery Date <br /> REM • <br /> V,1 :310i_rr - 1 C _ H <br /> rib - <br /> Ite Name - Phone No <br /> =-I <br /> Ann t ` vI :3co road L more ' Ca C,A 55C, <br /> lereby certify that the above named material has-been accepted and to the best of my knowledge the foregoing is true and accurate <br /> 1 Aulhorszed A ent Si nature Receipt Date - <br /> PASS CODE <br /> 6 BFi260 720 <br /> GENERATOR RETAIN <br />