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Waste* Na. 9159-80 <br /> Systems <br /> TM <br /> BROWNING-FERRIS INDUSTRIES N QN-HAZARDQUS SPECIAL WASTE <br /> MANIFEST , <br /> GENERATOR <br /> r <br /> Generator Name Generating Location <br /> Address 450 E. GPPNk T= ILIAD Address G i <br /> MACX, CA 95376 <br /> SCte <br /> 5 9 3 3 {..:�._ <br /> F7 <br /> Phone No. Phone No. �- t3 3 5 9 .1 3 <br /> BFI Waste Code © f7 S r D ! q L Z 3 33 Q Containers Type <br /> Description of Waste Quantic Units No. T pe D'- Drum <br /> ` C-Carton <br /> So, 1 til A1°St?l © � B-Ba <br /> 9_ <br /> T -Truck <br /> LLI ❑ m ❑ P -Pounds <br /> Y-Yards <br /> ❑ m ❑ 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 applicablo,state law, has been properly described.' <br /> classified and packaged, and is in proper condition for tra portation according to applicAle regulations. <br /> BOB Fps, PQM � 4� 0 2- 6 Y z <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> Truck No. 7 �. Phone No. <br /> Transporter Name 4 `� ` Driver Name (Print) <br /> Address � }'� � �-' Vehicle License No./State_ S2'7./ <br /> aAJ �� ��� Vehicle.Certification <br /> I hereby certify that the above named material was picked,up I her y ertify that the above named material was delivered with- <br /> at th=nerator listed above. out i tide it to the destination liste below. <br /> C) <br /> �e <br /> Driver Signature Shipment Date Driver Signature -Delivery Date <br /> i • <br /> Site Name Phone No. <br /> Address <br /> I hereby certify chat the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> N )f Authorized Agent Signature Receimt Mle <br /> PASS CODE <br /> 10/85 .. B 0 <br /> UNLOADING AREA CQPY <br />