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ast e. No. 9160;W � Systems Tit NON-HAZARDOUS SPECIAL BaOwNINFERRi$tNnusrRtes WASTE MANIFEST GENERATOR Generator Name Generating Location { Address 450 E. GRAN". M FOAD SAMEAddress TRACY, CA 95376 SAIF Phone No. .2 0• 9 g•_;.3.... 5... g:.. 1 33.:• ...:°" ;`" .:Phone.No. 2 0. 9 `� 8 3- 1 5 9 1 3 .3 BFI Waste Code �. S Ft TT iiO Containers Type Descri tion .-ww,e�;; , m•m QuantityUnits No. Type D'drum B-Ba D E C p4 1992 T-Truck 1 P -Pounds ENV ; ; "' �! 1 Em Y-Yards ERM 1 1 Y OP"NO � m � 0.Other _ I hereby certify that the.-above.named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable state law, is nota hazardous waste as defined.by 40 CFR Part 261 or any applicable state law, has been properly described, classified and packaged, and is in proper cond' 'T for tr sportation according to applicable regulations. a BClElFAGMMES PLANT Nit Generator Authorized Agent Name 'c"-Signature Shipment Dale TRANSPORTER `- I-k �,-C Phone No. `� i Truck N� 1 Transporter Name,,. Driver Name (Print) �}LS 5 �y r ttGlr/C L- Address Vehicle License No./State f0<r - i ,Vehicle Certification I hereby certify that the above:named,material was picked up: I hereby certify that the above named material was delivered with- atthe generator site listed above... :out incident to the destination listed below. o e riv ignature Shipment Date iver Signature Delivery Date DESTINATION Site Name Phone No. L�W F Address I hereby certify that the above named material hasbeen accepted and to the best of my knowiedge th for Ding is true and accurate. A. i 81 Authorized Agent :. ..>:....,: ..: Signa _ _ Receipt Dale tore:;:a .•::. PASS CODE BF1260.720 10186 UNLOADING CCIPY ;