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NON-HAZARAVS SPECIAL WASTE;&l�iBESTOSIMANIFEST '. If waste is asbestos waste,complete Sections 1 II,III end[V. - "Nle, 611413 . - If waste Is' QJ asbestds waste,complelip. l*Sealians I,B and III _ a Name: ARCO PRODUCTS COMPANY ti. Generating Location: ARCO STATION #00595 . - POB 5077 - d. Address: 6100 N. HWY 99 BUENA PARK, CA 90622-5077 STOCKTON, CA e. Phone No.: (925) 299-8891 PAUL SUPPLE I. Phone No.: N/A K owner,of the generating facility differs from the generator,provide: ARCO PRODUCTS COMPANYSame as I(e) g. Owner's Name: h. Owner's Phone No.: TYPE FN A 4 0 .5 0 9 2 0 9 0 2 215 7 I. BFI WASTE CODE m Containers DM-METAL DRUM DP -PLASTIC DRUM NON—HABARDOUS SOILB -BAG J. Description of Waste: k T -TRUCK Oa0 O - E0 1 O -OTHER or WAntity Linits No. TYPE BA -6 MIL C BAG GENERATOR'S CERTIFICATION: I hereby certify that the above ed material's not a hazardous waste as defined by 40 CFR Part 261 or UNITS any applicable state law, has been property described, classifi and packaged,and is in proper conditionfor transportation according to P -POUNDS applicable regulations;AND,If the waste Is a treatm Idue of a p?evlo 4f�esWcted hazardous waste subject to the Land Disposal Y -YARDS Reshictions,I certify and warrant that the waste h been tr n accorda m with the requirements of 40 CFR Part 268 and is no longer a M' -CUBIC METERS hazardous waste as defined by 40 CFR Part 261. ]le Teest)Of ARCO PRODUCTS COMPANY Y' -CUBIC YARDS 0 -OTHER PATRICIA DILLARD—DILLARD d Generator Authorized Agent Name Signature - Shipmem Date +c ku`• �,Iransporter3completee-g ;§ ANSPORTER, &,,- torcompletead; Trans rterlLcom leteh-in TRANSPORTERi TRANSPORTERII a. Name: AJ 44V _ h. Name: b. Address: PP;9 ciK //—,/q 1. Address:a Driver Name/T@le: S7 -- .UZL - - j. 'Driver Name/r'rtle:` _ I PRIWI YPE PRINL/LYPE d. Phone No.:7,d> g� ng@G6Z e. Truck No.:LLVE k. Phone No.: I. Truck No.: I. Vehicle License No./St=eceh tin�/L S� m.Vehicle License No./State: Acknowl gemea)s. ggAcknowledgement of Receipt of Materials. n. D' nazure ryy. Sni rent Date Dever Si nature Shi meM Date �BCYIOD.III„ - -^DESTINATION `denarator completes a4,destinationsae completes efi.) a Site Name: c. Phone No.: BFI — VA�ZCO ROAD SANITARY LANDFILL (925) 447-0491 4001 N. VASCO ROAD 4001 N. VASCO ROAD b. Physical Address: d. Mailing Address LIVERMORE, CA 94550 LIVERMORE, CA 94550 e. Discrepancy Indication Space: I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. fJOB# 1007-128 f. 1111 1 PO# 09-31515 Name of horizetl Agent signature Receipt Dare S ion IV"'` - `.' ASBESTOS -(Generator compote ad,°, „Kipe.) - - a. Shippers's• Name: b. Shippers's•Phone No.: a Shippers's"Address: d. Shippers's Special Handling Instructions and additional information: CERTIFICATION: I hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are classified, packaged, marked,and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national governmental regulations.