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15:35 D I LLARD-ENV*** 9166565277 0 NO.934 903 <br /> 1 1 •. <br /> rAR �: SIL WSA:�BESTOS MIANi FEST <br /> "P If waste is esWslas waste,comptate Sactiane Y,"If,i4I and IV_ No. .786753 <br /> It w&Ste 18 NOT asbestos waste,camplets.pltly 64011ons 1, 11 and Ill. <br /> MEN <br /> a. flenetator Nanta:" 'ARCO Pr'oducta CoMP"y Arca Station a 5450 <br /> , COMP"y . t}. �fiaetteralift0 Location"-_ - -_—_---__---_ <br /> c. Address: - lis8".S. Bstao.Om Ave. Ste, *202 d.Address: 1617 West Fiemorit 0 1-8 <br /> Ca bell, CA 95008 Stockton, CA <br /> e. Phone No.: (408)_ 377-86916 f. Pltore No.; none _. <br /> If owner of the generating facility differs from the generator,provide; <br /> g. Owner's Namw Arco ,Produe tt h- Owner's Phone No.: St3me es I(s) <br /> t <br /> TYPE , <br /> 1. BFI WASTE CODEA 4� U �� 3 1 9 ' $ 2 Contsinera 0M-METAL DRUM <br /> L 1 OP -"PLASTIC DRUM <br /> 8 -SAG <br /> J. Dw;ortption of W&sle: Inion Razardous Soil jTPRg j k. [luantlt units No, TYPE BA -6 MIL. PLASTIC BAG' <br /> -- or WRAP <br /> T -TRUCK <br /> OTHER <br /> GENERATOR'S CERTIFIGATEQN:1 hereby certify that the above named material is rpt 8"hazanjous wasi8 86 dbliftd by 40 GFR pert 26► UNITS <br /> or any applicable slate law,has been properly de-wcri6ed,classified and pa aged,and is In proper contlltton for transportation eCCOrding tc P -POUNDS <br /> applicable regulations;AND,If the waMd is a t"atment residue of a Ara Wesly rBStYicted hazerdeue waata subject to the Land Dlsposal Y -YARDS <br /> Restrlcii0ns,I OArtify and warrant thV the waste has been tt Odin a=o dance with the requirements of 40 CFR Part 268 and <br /> is no Iftger M3-CUBIC NIETERS <br /> a'hazardoua waste as defined by 40 CFR Part zenY3 •CUBIC YARDS <br /> .It t eclue t of ARCO Products 0 -OTHER <br /> .leash~ Drake ! <br /> Generator A0hvrIzed"Agent NM& ,gnaws Shipment Dale t <br /> i <br /> i <br /> I <br /> TRANSPORTER TRANSPORTER 11. <br /> Dillard .Tiutcklrtg, Ltti`. <br /> e. Name: _ _-- h. Name: .....,, <br /> b. Add rasa: !a Box 718 i. Address, _ <br /> 19yron, GA S4 514 —- -- --- -- – – -- — j <br /> c. Driver NametTltle: f �t; f.,,.v ;% } .� l _ <br /> I.. Ddvt3r NamelTitfe:"_ <br /> FRINTITYPE 'ry PRINTfTYPE <br /> d. Phone No.: f 510� 634-6850 e. Truck No.: _�� w � _ k, Phone No.: I. Truck No,; <br /> f, Vehlcie License NOL ISlat@. ^5 t 1 M.Vehicle License No.JSlaM <br /> Acknewledgerrlertt,o# Rsceipt.of Materials. " AcknawWdgernent of Receipt of Materials. <br /> 9 n-DrK4r uis empr!ent oats" DftverSigAIII ro uIpment oats <br /> a. Sita Name: t3PF Ver=0 Rd. bandfi I 511.) .447-0491 <br /> b. Physical Address: 4401 North, VftgC0 Road d. f,+Ialling Address. 4001 North 'Vasr.o R6ad <br /> Livermore, CA 94350 Livermore. C� 94550 <br /> e. Discrepancy indication Space: — <br /> I hereby certify that the ahoye named material has been aCceptedd and to the best of my knct_vledge the foregoing is true and accurate l <br /> J08# 2006;46 - <br /> Name Of AWharhM Agent signature Repplp!sore PO* 09-20394 i <br /> I <br /> a, Operator's* Name: h. orerator'e{ Phone No.: <br /> a. Oparasor's* address: <br /> d" Special Handling Instructions and additional Information: <br /> I <br /> OPERATOR'S CERTIFICATION: I hereby declare that the contents of this eonsipnrnsnt are fully and accuratetydescrlbed above by proper shipping name and are.dasaified, i <br /> packed,market,and labeied,and are In all respects In pfoper canditfon [or transport by highway according to applitlW6 hittrrtaliortal and gOvOTAMON regulations. <br /> t <br />