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J <br /> 1 - -rr�SL� ---- v- ---- — 9FI- acct .- No-­1100904 2--- --- - N,--9n_7_9 9 5 <br /> S]/Stet1'1S TM NON-HAZARDOUS SPECIAL WASTE I <br /> ROWtJING-FERRIS INDUSTRIES S E MAN FEST <br /> R Mid Cal Leasing 1643 E . Channel Bt <br /> venerator Name Generating Location <br /> F Q_ Box 55103 'Stockton , Ca <br />�ddress Address <br /> 'tockton . C_- _ 135205 <br /> =_I hone No Phone No �— <br /> AContainers Type <br /> FI Waste Code <br /> Description of Waste QuantityUnits No T Pe D Drum <br /> Diesel Contaminated Soi ) t ElC - Carton <br /> m <br /> S - Bag <br />' ❑ ❑ T -Truck <br /> P - Pounds <br /> Y - Yards <br /> QL _ J� F] O-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 transportation according to applicable regulations <br /> P, R7nehar•t � <br /> nerator Authorized Agent Name Signature Shopmenl Date <br />�uck No 7 _ 0 ii5 Phone No <br /> M P Envinons�tpntal Ser �ices /} <br /> rransporter Name Driver Name {Print) ( ag 14-e <br /> 400 Manor, Street_ <br />[dress - Vehicle License No /State Z S 2 7 f-> R G J`<, cT 64' <br /> Vehicle Certification <br /> lereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> it the generator site listed above out Incident to the destination listed below <br />,river Signature Shipment Date Dnver Signature Delivery Date <br /> i + 0 <br /> �r sca Road 5ar-li t'-r—Y Landfill C � � � A _ � � <br /> e Name Phone No <br /> dress 1001 Vaz= rcac� Live-Trio-e Ca 94551? <br />�reby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> Authorized gent RaeWavis <br />' PASS CODE <br /> 6 BF1260 720 <br /> GENERATOF RETAIN <br />