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�.��.. �fl. 9•�5.9.4 <br /> •SystemS TM <br /> t-ROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR1 <br /> G ator Name ' '' "' Generating Location <br /> Address 450 E. GRAM=� R:IA] Address <br /> PAG'Y, CA 95375 SAME <br /> 'Phone No. Phone No. . <br /> i <br /> BFI Waste Code LCIIAJ L41D S -i I 1-Lo I ( Z ?j q -3 O Containers Type ' <br /> Description of Waste Quantit Units Na. T e D-Drum <br /> �.�'' .5�;1 ��I•Se� ( � <br /> E <br /> [Ell <br /> �f C-Carton <br /> u B- Bag' <br /> T -Truck <br /> ❑ m ❑ P-Pounds 1 <br /> Y-Yards <br /> Elm F1 »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'appll jabs state law, has been properly described, <br /> classified and packaged, and is in proper con ' 'on for/(r asportation according to applicable regulations. <br /> BOB FAGUNMS, PLANT MANAGER I' �(/� ,t o 12 b Z <br /> Generator Authorized Agent Name Signature _ Shipment Dale <br /> TRANSPORTER <br /> ,r", �• <br /> TrQNO. " ? Phone No. <br /> Transporter Name Driver Name (Print) <br /> Address Vehicle License No./State_�16��Z <br /> Vehicle Certification <br /> i <br /> 1 hereby certify tha ove named material was picked.up _ I.hereby certify a above named materia[ was delivered with- <br /> at the to Ite list ab 0 t#er1 the estinat' listed b <br /> VV <br /> Drive 1gna Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> ' n I <br /> Site Name Phone No. <br /> Address <br /> [.hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> Name.ol Authorized A eni SI nature <br /> Receipt Oale <br /> PASS CODE ! <br /> 1018e BF1260-720 <br /> • UNLOADING AREA COPY . <br />