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0cch Waste No. '9'1 G O 4;1' <br /> ' S]/Stet � <br /> BROWNING-FERRIS INDUSTRIES TNON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> ES <br /> GENERATOR <br /> Generator Name Generating Location, <br /> Address 450 E. GRAN ME ICAD Address SANTE <br /> TRAt;:Y;-.CA 95376 ,' SAME <br /> ,Phone No, . ,9 ... rlt,. : 9 Z: .3. 3 �:"Phone.Na: <br /> k { A Li b S ! o I q Z 3 3 3 O Containers Type <br /> BFI Waste Code �. D-Drum <br /> Description of Waste Quantit Units No. Type <br /> Carton <br /> r' sail 1~l <br /> I's e. B- Bag <br /> T-Truck <br /> Elm 1-1P - Pounds <br /> Y-Yards <br /> Ej m � O-Other <br /> I hereby certify that the above named material does not contain free liquidas 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 /> w classified and packaged, and is in proper cond' 'onfor <br /> ;�s <br /> portation according.to applicable reygulations. <br /> Generator Authorized Agent <br /> PP�. ignatura ::::.' ...'Shipment Date <br /> TRANSPORTER <br /> Phone No. <br /> Truck No. <br /> � 1 <br /> Transporter Name Driver Name(Print) <br /> 'Address Vehicle L-,Zicense,No./State <br /> e V Tele Ce tifi�ation <br /> .1 r f't <br /> he above named <br /> material was delivered with- <br /> above material vvas� icked u t ,ghY-oe��a <br /> I hereby certify that the above name P p <br /> at the generator"site listed above. ut incident to the destination listed below. <br /> k <br /> i <br /> Dery 'Y Dale <br /> r Si nature <br /> Delivery <br /> Driver Signature '�1�� r. Shipment Date". ve g , <br /> DESTINATION <br /> Site Name Phone No. <br /> 1. 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 /> of Authorized Age..nt St nature-Q 'Receipt uale <br /> .iA:t. <br /> PASS CODE I <br /> t BF1260.720 <br /> J0186 <br /> UNLOgDING' AREA COPY <br />