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nacn . <br />SKID <br />,;«01" • MANLEY & SONS`e <br />.LL. ` Trucking & Equipment Rental <br />curare 8896 Elder Creek Road <br />• • ' Sacramento, CA 95824 <br />Generator Name <br />No. 002886 <br />NON -HAZARDOUS SPECIAL WASTE MANIFEST <br />GENERATOR <br />California IFL1'1K Lirlf36 Generating Location Sart© <br />Address j105 aouth 1:,1 Doradoit. <br />Stocktotl, Cu. `>5 06 <br />Address <br />Phone No. !� `3 4 1 6 6 1 3 5 5 Phone No. � <br />`u' <br />Waste/Acceptance Code U U U ` Containers Type <br />r1 <br />D D <br />Quantity Units No. <br />Type <br />- rum <br />m <br />- Carton <br />B <br />B •Bag <br />m <br />❑ <br />T - Truck <br />P- Pounds <br />Y- Yards <br />71 <br />Elm <br />1:1O <br />- 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 />1 <br />Generator Authorized Agent Name Signature Shipment Date <br />TRANS• • <br />TER7 <br />Truck No. i "T i Phone No./G <br />Transporter Name ,4'2 4 L -L k -2. 5 n/V S Driver Name (Print) -T���+.` Y9 �' C l �i�Tc�t /V <br />Address .5 9l Vehicle License No./State �C �� '/Uk`�c'`L� <br />.r.,f X44 + iv�Tn /9 Vehicle Certification <br />t� vv -7 -7-7 <br />I 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 />A/ <br />Fain , _s river Sionatura '1 Delivery Date <br />Site Name <br />Port Gostrl niateriri.la Phone No. 5 U — u 1 <br />900 Iiar".111itioz 3ce.fli_c: Ov., iloc't cjoat,tt l%c'L. IfcF 69 <br />Address ' <br />I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br />PASS CODE <br />White -DESTINATION Yellow -UNLOADING Pink -TRANSPORTER Gold -GENERATOR <br />