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Waste <br /> Systems TM Na. 915§4 8 } <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> Generator Name DAPM: PRDDIXTS CC IJPANH <br /> E Generating Location SAVE <br /> Address 450 E. GRAN IjM I? <br /> Address_ SAME <br /> TRAcy, CA 95376 <br /> SAME <br /> Phone No. <br /> Phone No. ' <br /> BFI Waste Code C O S 0 g 9 Z q 3 Containers Type- <br /> Description <br /> of Waste Quantit D-Drum <br /> Units No. T pe <br /> ki C-Carton <br /> 0 Lt- I B -Bag 1 <br /> W T -Truck <br /> _ P - Pounds <br /> EI= Y-Yards <br /> ❑ m 1-1 <br /> 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 /> classified and packaged, and is in proper condition for tr sportation according to applicable regulations. <br /> L Cl,�(. • <br /> Gensrater Authorized Agent Name Signature ` D ` <br /> Shipment Date <br /> r <br /> Truck No. / V <br /> Phone No. <br /> Transporter Name F �''�5a ,✓ <br /> Driver Name (Print) •*Q K uF, G� <br /> Address Vehicle License No./State <br /> Vehicle Certification <br /> I hereby certify that the.above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the generator site listed above. out incident to the destination listed below. <br /> iU q G 9 <br /> Drivdr Sig�i-rl Shi lent Date <br /> P Driver Signa re Delivery Date <br /> 1 <br /> DESTINATION <br /> Site Name Phone No. �— I <br /> Address ,- <br /> I hereby certify that the above named material has been accepted and to the best of wledge the foregoing is true and accurate. <br /> Ir' '1 Authorized-A enY <br /> t "Si nature <br /> Receipt Dat <br /> 10186 PASS CODE <br /> • a SFI260-720 <br /> Ias • ...... - <br /> .. U NLOA <br /> D! <br /> N <br /> G AREA C <br /> OPY - - <br />