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a - <br /> r No: 915:940 <br /> YStems TM <br /> BROW%W.NG-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name ;�;}�' :: ]:E.c� a;%.'.:':, f ' �tiy <br /> Generating Location <br /> Address 450 E. GRANT= FAD Address SAME.- <br /> TRACY, CA 95376 SAME <br /> Phone No.' 2 0 9 "8-; 3 5 9 3 3 Phone No. 2 '4, 9 8 3 . 5 9 1'. ,.3 3 <br /> Containers <br /> BF] Waste Code d S- d 1 9 3 b T . <br /> Descri tion of Waste QuantityUnits No. T e D Drum <br /> r C-Canon <br /> s} w f QSf�I 1 c B-Bag <br /> 5 i f <br /> T-Truck <br /> F-1 m ❑ P -Pounds <br /> Y-Yards <br /> - � ❑ m ❑ 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 /> - <br /> classified and packaged, and is in proper condi ' for t portation according to applicable regulations. <br /> BOB FIfGRMES, PLVU MMMGER ! .'O "°Z 1 Z <br /> Generator Authorized Agent Name Signature `a Shipment Date <br /> 70 <br /> i Truck No. Phone No. -3 <br /> f. . .• � `� rlf { <br /> Transporter Name e f fiver ame (Print) <br /> tJ <br /> Address (F Vehicle License No./State <br /> Vehicle Certification <br /> hereby certify that the above named material was picked u I hereby certify that the-abo a named material was delivered with- <br />' at the generator site list a ove. out incident to the destinat' n listed below. . <br /> ODelivery Date <br /> rive gnatun Shipment Date Df+�r Slg atu <br /> DESTINATION/ <br /> Site Name J 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 /> •.t �f:Authorized Agent.. ;.. .. . a ....: .'.... - --- Receipt Date <br /> 5i nature <br /> PASS CODE <br /> SF1260-720 <br /> 10186 " — • <br /> 3 -UNLOADING :ARE-A-•GOiPY <br />