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waste <br /> 4 No. 915937 <br /> fi Systems TM NON-HAZARDOUS BROWNING-FERRIS INDUSTRIES SPECIAL WASTE MANIFEST <br /> w <br /> GENERATOR <br /> Gene`ator Name Er i-VITJ. 1; 1'11Y ;IIIA_ s C'C^'i'7?:;i _- <br /> Generating Location <br /> Address 450 E. GRADMIM E ROAD Address SAME <br /> TRACY, .CA 95376 ME <br /> Phone No. r 2 0 8. 5:' 9 1� 3{ 3 P <br /> 5 9 3 111, <br /> h ii <br /> a e o. 8 3 ' l , <br /> BFI Waste Code m � Lt _j 2 _`t _ L-? 3 oContainers Type <br /> Description of Waste T Quantity Units No. T pe D- Drum <br /> ] -Carton <br /> B <br /> u -Bag ? <br /> T -'Truck <br /> ❑ m ❑ P -Pounds <br /> Y-Yards <br /> ❑ m ❑ 0-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 fort nsportation according to applicable.regulations. <br /> BOB Fes, PIAW MAIUVMRR�C) L U Lll� ! �f b 12- 11, ZGenerator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> Truck No. Phone No. <br /> Transporter Name Driver Name Print <br /> p (Print) <br /> i <br /> Address O Vehicle License NoJSt t <br /> Vehicle Certification <br /> I here y certify th a above named material was picked up I erebyicertify tha.ttte ab ve name material was delivered with- <br /> f � <br /> at the gener r siteZst7 <br /> t 1�t Pncident to edestin ion It e w <br /> r r ; <br /> er Si re Shipment Date-r...' Dover Signa ra Delivery Date <br /> DESTINATION <br /> Site Name Phone No. <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 />,Harr.- -Authorized Agent Signature Receipt Dale <br /> PASS CODE <br /> 10186 SR260.720 <br /> � . <br /> UNLOADING:.ARBA COPY <br />