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r <br /> -HAZARd;6S-4PECIAL WASTE 81 :.613l.�T0S MANIFEST <br /> If waste is asbestos waste,complete Sections I,a,III and IV. No. 611403 <br /> If waste is NOT asbestos waste,complete only Sections I,U and III. <br /> ENE" <br /> terata Name: ARCO PRODUCTS COMPANY b. Generating Location: ARCO STATION #00595 <br /> tress POB 5077 d. Address: 6100 N HWY 99 <br /> BUENA PARK, CA 90622-5077 STOCKTON CA <br /> me No.: (925) 299-8891 PAUL SUPPLE 1. Phone No.: NSA <br /> err of the generating facility differs from the generator,provide: <br /> nets Name: ARCO PRODUCTS COMPANY In. Owners Phone No.: Same as I(e) <br /> TYPE <br /> WASTE CODE [CA 4 0 5 0 9 2 0 9 9 0 2 2 5 7 Containers DM-METAL DRUM <br /> DP -PLASTIC DRUM <br /> B -BAG <br /> stxiption of Waste: NON-HAZARDOUS SOIL k. Quant BA -6 MIL PLASTIC BAG <br /> or WRAP <br /> 0 0 O Y 0 1 T T -TRUCK <br /> O -OTHER <br /> NERATORS CERTIFICATION: 1 hereby certify that the above named mat net is not a hazardous waste as defined by 40 CFR Part 261 or UNITS <br /> y applicable state law, has been property described_dassfied and pa aged, and is in proper condition for transportation according to P -POUNDS <br /> plicable regulations;AND,If the waste is a tre lint rejI ue of a pre4ou�(y restricted hazardous waste subject to the Land Disposal Y -YARDS <br /> astrictbns, certify and wanant that the waste h been freer m r�ddnce WRh thh�uiremeras of 40 CFR Part 266 and is no longer a M' -CUBIC METERS <br /> aardous waste as defined by 40 CFR Part 261. thy` t quest f5f ARCO P O -OTHER <br /> y3 -CUBIC YARDS <br /> �� <br /> ***nRn-n7r r aan <br /> enerwor Authorized Agent Name Signature Shipment Date <br /> � 0 Transporter f complete e� - <br /> e , 'TRANSPORTER (Generator complete aa: Transporter If complete h-n� <br /> TRANSPORTERI TRANSPORTERII <br /> DILLARD TRUCKING, INC. h. Name: -inns: — <br /> Mreas: <br /> POB 579 . i. Address: <br /> BYRON, CA 94514 <br /> iver Name/rdle: - j. Driver Name/Title: PRIM/fYPE <br /> PRINTI YPE I. Truck No.: <br /> tone No.: <br /> 925-63d-6850 e. Truck No.: k. Phone No.: <br /> )hicle License No./State:SP A/S q15_0 m.Vehicle License No./State: <br /> *nnoowllee7dgement of Receipt of Materials. q Acknowledgement of Receipt of Materials. <br /> n. - <br /> l`�^ Shi mann Date Driver Signature Shi ment Dale <br /> yens oats <br /> 3t <br /> 10f1: DESTINATION (Generator completes a4,destination site completes e-f.) <br /> 1 ::I)� - <br /> rte Name: BFI - VASCO ROAD SANITARY LANDFILL c. Phone No.: (925) 447-0491 <br /> tiysical Address: <br /> 4001 N. VASCO ROAD d. Mailing Address 4001 N. VASCO ROAD <br /> LIVERMO':E, CA 91550 LIVFRMORE, CA 94550 <br /> iscrepancy Indication Space: - <br /> nereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> JOB# 100"7-128 <br /> r/ PO# 09-31515 <br /> amd Auaroraea Agent Signature - Receipt Date <br /> ::ticni <br /> - "' A$BE$TO$ (Genereto complete edi a Sh'pper•completese) <br /> ;hippeWs*Name: b. Shippers's`Phone No.: -. <br /> ;hippers's•Address: - <br /> ;Nppers's Special Handling Instructions and additional information: — -- <br /> ffIP1CATION: I hereby declare tltat the contents of this corsigiiiimtt are fully and accurately described above fry proper shipping name and are classified, packaged, <br /> mental regulations.aid,and labeled/placarded,and are in all respects in proper owtdrtion for transport according to applicable international and national govern <br />