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Wa"Me <br /> �, : .�. No. .9-1,&0 3 6 <br /> ' -' . <br /> Osyttems zMw <br /> BROWNING-FERRIS INDUSTRIES NQN HAZjARDOUS' SPEC{AL WASTE MANIFEST. <br /> GENERATOR <br /> Generator Name f)OANE, Generating Location <br /> Address 450 E. GRAN LINE ROAD Address SURE <br /> ; TRACY,CA A 95376. SANfE <br /> ,Phone No. 2 9 $`/ `3. S 9 3 3 Ptione No.�- <br /> BF! Waste Code S v ` 3' Containers Type <br /> `T 3 3 d I <br /> Description of Waste QuantityUnits Ne. T e D-Drum C-Carton <br /> aO T B-Bag <br /> T -Truck <br /> El m ElP -Pounds 1i <br /> Y-Yards <br /> m � d-'Other � , <br /> k 1 hereby certify that the.above named material does riot contain free liquid as dbfined 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 Jaw, has been properly described, <br /> classified and packaged, and is in proper co ' Ion for nsportation according to applicable regulations. <br /> -T <br /> Bob FAarrrMW� 4 w , z <br /> Generator Authorized Agent Name :.:Signature Shipment Date <br /> TRANSPORTER <br /> Truck No. <br /> � Phone No. <br /> Transporter Name VA. Driver Name (Print) <br /> Address +�� Vehicle license No./State — <br /> Vehicle Certification <br /> Thereby 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 above. out incident to the destination listed below. <br /> ::•ShI mens Date ignature.. / Delivery Date <br /> Driver Signature p f e <br /> DESTINATION <br /> Site Name Phone No. <br /> Address <br /> I hereby certify.that-the.above.named material.kas been;accepted and:to the best of my knowledge foregoing is true and accurate. <br /> me o!-Authorized Agent S nature'.. <br /> PASS CODE <br /> 072(26 <br /> i <br /> UNLOADING'AREA COPY <br />