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01 <br /> No. 91.6 044 <br /> Systems TM. N <br /> BROWNING-FERRIS INDUSTRIES ON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name Generating Location <br /> Address 450 E. GRAN L= ROAD Address SM ; <br /> ,.:'TRACy, CA 95376 SAME <br /> - <br /> ! .AY�!fi Se '•raa .Y, r r:' ey` '.� � 'j� �q } 1 .:tt� � � +�y ,•a� , <br /> ' 4 a �:. •�_ "'h71' %' ��• � .i -T p 4�i V'��- r { :7s -1° �J <br /> r_ Aholzerlo 7 w , f .t?1t0r1e Nor/ i r <br /> BFI Waste Cod 'L_L_Lv l i 1 1 R Z 3 `l 3- 3 O Containers Type <br /> Description of Waste Quant ty Units No. Type D- Drum <br /> C-Carton <br /> Y O Efl B - Bag <br /> T -Truck <br /> P -Pounds <br /> m Y-Yards <br /> x- <br /> E D 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 /> classifiedand packaged, and is in proper Condit! for,tr sportation according to applicable regulations. <br /> ECB FAGMZ=, PXANT MUMGME!/J 110 2- 9' Z <br /> Generator Authorized Agent Name '- Signature Shipment Date <br /> TRANSPORTER <br /> I� Truck No. X' Phone No. <br /> y <br /> Transporter Name �e5 U���l�P !U Driver Name (Print) <br /> Address Vehicle License No./State <br /> s <br /> Vehicle Certification. <br /> I hereby certify that the above named materiai'was picked up . 'i I hereby certify that the above named material was delivered witt <br /> at the generator site listed above. -out-incident to the destination listed below. } <br /> /bdvy Signature —Shipment Date : Dr er Signature Delivery Date E <br /> Li <br /> DESTINATION <br /> Site Name Phone No. <br /> -Address <br /> I hereby certify that the above named material has been accepted and to the best owledge the"foregoing is true and accurate. <br /> ie of Authorized Agent S nature>•a w "'`Receipt Date'' <br /> PASS CODE <br /> SF1260.72 <br /> i• <br /> . UNLDAGiNG' AREA.C : Y.. .. .. . .:;:. :. <br />