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OSystems <br /> Waste , 00s04z �o sops$ $TM NON-HAZARDOUS SPECIAL WAST ! <br /> BROWNING FERRIS INDUSTRIES E MANIFEST <br /> FEST <br /> • <br /> Mid Lal Leasing 1649 S _ Channel St <br /> venerator Name Generating Location <br /> P Q 6a�e 55103 Stoel�ton , Ca <br />�ddress Address <br /> 3ror_kton _n _ 95205 <br /> -5 D <br /> hone No Phone No <br /> Al 4C3 5 ' - <br /> BFI Waste Code L T I Containers Type <br /> Description of Waste Quantity units No pe D- Drum <br /> Diesel Contaminatred Soil ] Elim El C -Carton <br /> B - Bag <br /> ❑ m ❑ T -Truck <br /> 1 P - Pounds <br /> Y - Yards <br /> El m F-10-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 cdndition fo"Tansportat on accor ing to applicable regulations <br /> Ronald K Ri nehar rrV <br /> ienerator Authorized Agent Name Signature Shipment Date <br /> truck No Phone No <br /> l-ransporter Name M P Environmental Services I_IV <br /> ZDriver Name (Print <br /> i <br />�ddress 3 100 M,nor 3treet (�C� <br /> Vehicle License No/State ' <br /> Vehicle Certification <br />`hereby certify that thq above named material was picked up I hereby certify that the above named material was delivered with- <br /> 3t the generator site 9ted above out inerde t to the destination listed below <br /> fiver Signature Shipment Date Driver Sig ature Delivery Date <br /> 'Vasco Paced Sanitary Landfill <br /> site Name P i 0 <br /> Phone No F <br />[dress <br /> a 00 i `v`asco Road , Livermore . Ca 94550 <br />�ereby certify that the above named material has been accepted and to the best of my knL wledge the foregoing is true and accurate <br /> F Authonzed i ent Signature Recetpt Date <br /> PA-_�, CODE <br />�as BF1260 720 <br /> GENERATOR RETAIN <br />