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Waste No. 957249 <br /> aRovyNING-FERRIS INDUSTRIES NON—HAZARDOUS W' S) MANi1-_0T <br /> GENE.RATOR <br /> ' "aliforr.i.a r'edar California CP.; . <br /> Generator Name Generating Location <br /> Address 12418 E. Locke Road Address 12418 E. Locke Road <br /> Lorkeford. CA 95337 Lorkeford. Cra 95237 <br /> =—M74T4 5 8 Phone No. Phone No. <br /> BFI Waste Code C 4 0 5 0 1 2 1 1 2 9 3 4 9 9 9 1 Containers Type <br /> Description of Waste QuantityUnits No. T e D-Drum <br /> 0 0 0 1 3 l' 0 ( C-Carton <br /> 8 -Bag <br /> KO's HAZARDOUS T -Truck <br /> SOIL - ❑ � a P-Pounds <br /> Y.Yards <br /> a m <br /> El <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 JoU51risportation according to applicable regulations.. <br /> J 0 1 2 1 1 1 6 1 9 3 <br /> Generator Authorized Agent Nlam!e� i g tur Shipment Date <br /> TRANSPORTER <br /> / 510-634-6850 - <br /> Truck No. Phone No <br /> Dillard Trucking. Inc. <br /> Transporter Name Driver Name(Print) <br /> Address P. 0. Box 218 Vehicle License NoJState� ��` J <br /> . Byron. California 94514 <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 Incide i to the dost' tion listed below. <br /> 10 2 1 6 9 3 <br /> Drty Signature Shipment Date D 9"" DeNvery Data <br /> DESTINATION <br /> B.F.I. Vasco Road Landfill phone No. FT1 0 _ 4 x 7 0 4 9 1 <br /> Site Name <br /> 4001 North Vasco Rd. . Livermore. Ca. 94550 <br /> Address ' <br /> I hereby certify that the above named material has been accepted and to the best of wledge t o ng Is true and accurate. <br /> Name of Authorized Agent Signature Receiot Date <br /> PASS CODE <br /> 10186 M260-720 <br /> TRANSPORTER RETAIN <br />