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� rr NON-HAZARD US-SPECIAL:WASTE A.zrSESTOS MANIFEST .. 4- .ftwaste Is asbestos waste;oompletffi Sections I,IL M and IV. N O. 611-414 .. r If waste is NQS�sbestos waste,complete only Sections L U and!II. ARCO PRODUCTS COMPANY ARCO STATION #00595 a. Generator Name: b. Generating Location: POB 5077 6100 N. HWY 99 c. Address - d. Address: BUENA PARR, CA 90622-5077 - STOCKTON, CA e. Phone No.: (925) 29?-8891 PAUL SUPPLE f. Phone No.: N/A If owner of the generating facility differs from the generator,provide: ARCO PRODUCTS COMPANY Same as I(e) g. O*ner's Name: h. Owners Phone No.: TYPE _ A r-M 0 2 r I 1 2 5 I. BFI WASTE CODE Containers DM-METAL DRUM DP -PLASTIC DRUM NON-HAZARDOUS SOILB -BAG j. Description of Waste: k. Quantity0 0� m O -OTHER WRAPT -TRUCK BAG GENERATOR'S CERTIFICATION: I hereby certify that the above n ed material is not a hazardous waste as defined by 40 CFR Part 261 ori any applicable state law, has been property described, dassifi anq packaged,and is in proper condition for transportation according to P -POUNDS applicable regulations;AND,it the waste Is a trea Idu of a previously restricted hazardous waste subject to the Land Disposal Y -YARDS Restrictions,I certify and warrant that the waste h been in accords tTrLe re uirements of 40 CFR Part 268 and is no longer a Ma -CUBIC METERS hazakdous waste as defined by 40 CFR Part 261. Se s oAY2CO PRODUCTS COMPANY y' -CUBIC YARDS O -OTHER PATRICIA DILLARD-DILLARD Shipment Date Name Generator Authorized Agent Nae Signature - P , �Transporterloomplete 2 O R%>k�ISPORTERcoYin fete --Transporterhtl ti complete i _ TRANSPORTERI TRANSPORTERII a.Name: h. Name: b. Address: C J }tri-4 i. Address: c. Driver Name/Title IV cc j. Driver Name/Tdle: PRINT/TYPE PRINT/TYPE d. Phone No.: 1 � ' /G e. Truck No.: t•I1 k. Phone No.: I. Truck No.: f. Vehicle License No./State: c1 6 I�'1 O6 O m.Vehicle License No./State: Acknowledgement �o�f�Receipt of Materials. Acknowledgement of Receipt of Materials. � ISI I Dmer Sl nature Shl meM Date Diver Sl nature SN rrerrt Date CYIDTI ESTIFIATIOI�1 (Generatorcompletesa-d,destinaf�onsiternmpletese-t.) : ROAD SANITARY LANDFILL (925) 447-0491 + a. Site Name: ._ c. Phone No.: U AS 0 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 accurte. JOBI 1007-128 PO# 09-31515 flame of Auty sed Agent Signature Receipt Date *mss., �,_,,,' • SBESTOSLtlm plete a-0m ne ,f,g,Shipper•copielese} ' a Shippers's-Name: b. Shippers's- Phone No.. _ c. Shippers%-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 aboe by proper shipping name and are dassffiect narked,and labeled/placarded,and are in all respects in proper condition for transport according to applicable international and national govemmerttal regulations_'