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NON-HAZARINUS SPECIAL WASTE tB&*13cST0S MANIFEST If waste Is asbestos waste,complete Sections I,II,HI and TV.- .611416 . If waste Is NOT asbestos waste,complete only Sections I,II and III. No. .tom ARCO PRODUCTS COMPANY ARCO STATION #00595 merator Name: b. Generating location: _ - POB 5077 6100 N. HWY 99 1 '' khan d. Address: - ' BUENA PARR, CA 90622-5077 STOCKTON, CA "+i (925) 299-8891 PAUL SUPPLE N/A s' ions No.: I. Phone No.: _ $ ter of the generating facility differs from the generator,provide: - ARCO PRODUCTS COMPANY Same as I(e) vines Name: Ivry It. Owner's Phone No.: - TYPE I WASTE CODE A 0 0 2 0 2 2 5 Containers DM-METAL DRUM OP -PLASTIC DRUM NON—HAZARDOUS SOIL _ _ _ B -BAG ,.; tsrxlption of Waste: - - - k Quantity0 _ Om O -OTH Ror W �TYPE BA -6 MIL PLASTIC BAG' T -TRUCK If] 0 ,F14ERATOR5 CERTIFICATION: 1 hereby certify that the above nam4ed material is not a hazardous waste as defined by 40 CFR Part 261 or UNITS - - rhy,applicable state law, has been properly described, Gasified hind packaged, and is in proper condition for transportation according to p -POUNDS - pplicable regulations;AND,N the waste Is a treatrsent resldue qt a prevlously'restricted hazardous waste subject to the land Disposal Y r -YARDS estdctions,I certify and warrant that the waste has�i en tra d to e,den 'with the requirements of 40 CFR Part 268 and is no longer a M -CUBIC METERS - - azardous waste as defined by 40 CFR Part 261. requ t bf ARCO PRODUCTS COMPANY Y' -CUBIC YARDS _! O -OTHER .TRICIA DILLARD—DILLARD aneretor Authorized Agent Name Etignature Shipment Date .. . ' -. Transponer l complete eg. . _... TRANSPORTER (Generator complete e-d; Trans iter n com le a h, TRANSPORTER TRANSPORTERII h. Name: 1digss: «� L•^� 04` 't— I. Address: iver Name/Rde: /V�// {�o�!/mit 3 j. Driver NamefFitle: . ....-,. - F PRINT,TYPE -/ PRINTfTWE tone No.: tl:G iwr-�3) e. Truck No.: b k. Phone No.: I. Truck No.: - thicle License No:/State: 85/G�3 m.Vehicle License No./State: *nowledgement of Receipt of Materials. Acknowledgement of Receipt of Materials. n. ver S' nature Shi menl Date Dm rsi nature Shi men,Date On Ii DESTINATJ___P aatorcomple ea a-0,destination site completes a f.) BFI — VASCO ROAD SANITARY LANDFILL (92S) 447-0491 Is Name: c. Phone No.: 40 1 N. VASCO ROAD 4001 N. VASCO ROAD tysical Address: d. Mailing Address LIVER1,10RE, CA 945.0 LIVL'RIIORE, CA 94550 F saepancy Indication Space: hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. J,-)B# 1007-128 POii 09-31515 ace of Aur ed AgeM Signature Receipt Date 31016 TV` ASBESTOS"-(Generator complete a-d,f,g,Shipper-completes e.) iippers's'Name: b. Shippers's'Phone No.: iippers's`Address: - nippers's Special Handling Instructions and additional information: nFlCATION: I thereby declare that the contents of this consignment are fully and aoaxatdy described above by proper shipping name and are ed,and IabeieNplararded,and are in all respects in proper mnrfrtion for transport according to applicable international and rational governmental regrlatka�*.