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Waste <br /> S stems TM No. 915-939 G+ <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL W <br /> ASTE MANIFEST <br /> GENERATOR <br /> y r <br /> i- .e1.. ;-�_ 1� [ .�F�il.�.�ir <br /> GeQor Name g <br /> Generatin Location <br /> Address 450 E. GRANT= %?AD SAM � <br /> Address <br /> TRACY, CA :95376 SAM <br /> Phone No. 2:,...�,- _ g 3. 5 g 3 <br /> P'hone'Nn. ,A <br /> BFI Waste Code C R N vq Z y 1 3 1 3 U Containers Type <br /> Description of Waste Quantity Units No. Type D- Drum yy <br /> I I-t—I C-Carton F <br /> Y U ( t ` 1 B -Bag <br /> E= T <br /> T -Truck <br /> 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 applicable state law,. has been properly described, <br /> classified and packaged, and is in proper condition for tra portation according to applicable regulations. <br /> BW FAZEM, _ <br /> Generator Authorized Agent Name Signaturep _. Shipment Dale <br /> A"k TRANSPORTER <br /> jruck No. Phone No. <br /> r <br /> Transporter Name � Driver Name (Print) <br />,Address ' e� Vehicle License No./State <br /> Vehicle Certification <br />!I here certify that the above named material was picked up I here ertify that the above named material was delivered with- <br /> at th_ enerator site lis ed above, out i id nt to the destination lis d below. <br /> O (. 12 1 Zj <br /> Driver Signature Shipment Dale Driver Signature Delivery Date <br /> DESTINATION <br /> Site Name <br /> 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. j <br /> Name-r'outhorizedAgent- <br /> Signature.......; <br /> I <br /> ReCeipf Dale ' <br /> PASS CODE <br /> 10186 BF1260-7200 <br /> - . UNLOADING AREA COPY <br />