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I� -rite <br /> � No. <br /> - .. .. <br /> S]/Stel1'�S TAI 916 03.4 <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR . <br /> Generator Name .1•,.i: <br /> Generating Location <br /> Address 450 E. GRANT= SAD Address SAME <br /> i <br /> TRACY CA 95376 SAME <br /> $ 5 <br /> Phone No. Z `0 9 .3 .'g: ' I ..3 3. <br /> Phone No.; 2 Q 9 $ 3 5 9 T 3 3 <br /> BFI Waste Code E'' I-� 1 y S- 0 Z 3 R 3 3 0 Containers Type <br /> r j ` <br /> Description of Waste Quantit Units No. Type <br /> D-.Drum <br /> Sot i �1i��f C'-Carton <br /> r f E t I B -Bag <br /> T-Truck <br /> mP-Pounds <br /> Y-Yards <br /> Ll <br /> D <br /> m ElO-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 applicablestate law, has been properly described, <br /> classified and packaged, and is in proper con ' n for nsportation according to applicable regulations. <br /> _ BOB FAGS, PIANrL i 9 . y; o Z <br /> ,Generator Authorized Agent Name -:; Signature• Shipment Date <br /> Truck No. Phone No. 1_ �f 5 <br /> Transporter Nam UAPC Driver Name (Print) <br /> Address Vehicle License No./State , <br /> Vehicle Certification <br /> A. <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 a ove. - out incident to the destination list d beiow. <br /> K * O Z <br /> ver ure -Shipment Date <br /> 1-7 1P <br /> __77VriV6LMgnature / Delivery Date <br /> DESTMATI. r <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 /> >. <br /> N Authorized Agent <br /> Signature r=. Recefot Dete <br /> PASS CODE <br /> 10!8G BF1260 7 <br /> 2D. t <br /> UNLOADING AREA`CO,PY <br />