|
6V
<br /> 1.� ;F C I
<br /> �,VAS-
<br /> JL
<br /> F,,.�
<br /> kAW
<br /> Fr.',�T, `e.�• ,,,ti.I'r ...r''+� ' 'x` r .u�r i, _ _ :,..fie
<br /> . fi 7•_Z - r�•c`!� �j{,; -
<br /> _• 7 � � ` �tv� s,� rllonty„Qin
<br /> MIN 11 - r 4 r , � _-
<br /> .�' .� s y ry k _ a, r'� _ Ms c1'Y'_ :� .V f` 2- -9 r C'.~ i ^'',I�J1�{�fsI
<br /> e e � `n1� �`�+Y� s' x -Uu�ntt Units :`-No� �.
<br /> B ■1� �� .� -r — VIf Role - - �L A
<br /> r �Y„t. yy..y c ^„� ���' - �����p f�•��F'p�,ipY�e� tr��'6,�k�....� Y� � i�t �" - `. � ��
<br /> � 9 '�r e•' � ���'"`k���=,e��riy,a�"� r ti 4: �. �`�.,z� ^5' �Tr
<br /> `� ,.,f ta...c '- y. y _ ,„ E .t=yrs:
<br /> • v a+ -G r r1Ff�— fir- , _
<br /> X. .....
<br /> :a�'�' ,j5_•�„...,f n�s� . � � r^ c'�.. - -., - -_ '�Y �? ,�r•�h Y�- s
<br /> 1El
<br /> 674;4 t.5• +w �{9i'�i.4�L1'. - s��, '3" t 'i =t,�jLoQr
<br /> ^� � T_" r_ - d 4 a�Ly. LIY�+L Y� - �a��4�'- _ � „��i � C w ❑ � �� ��Vz uWa�+i,
<br /> V t.££w
<br /> „. si
<br /> A a $reby certify that
<br /> the, +$ pained material does not contain free liquid as defined by40Caw has been Properly�described.
<br /> �-,Mate law, Is not a hazardous to as defined by�f0 CSR Part 261 or any applicable ,
<br /> lassffled grid pacicaggct,_aA lsn proper Condition for transportation according to applicable regulations. a
<br /> • J 3Ytl( ��F?`r� �p Js ry r4.y ti�!3'!.-,g}-.a.' .t / Ci /�4j�}�t
<br /> ka
<br /> mp§
<br /> J f ^ s,. ti .. y wf a kg"L't,]i4+-'�Y {�'/'_"�
<br /> le
<br /> � rw r����-�- M + ` �-r _ ;d•G,, IGS•iy�a- :rtr.'. ,�Z. ,
<br /> Q0-5 +. -rW r
<br /> _ , r
<br /> ' phone No x
<br /> 4.• yS l ti♦-4004121
<br /> 0 l
<br /> n,��~t:s j ?4 • Driver Name (Print)
<br /> T77-e
<br /> 'tainsporter
<br /> �' '• r4- _; r.0. tBox -Zla ,; Vehicle License No./State
<br /> , Aadress
<br /> "
<br /> x- r .-CA + 4514 � ationByVehicle
<br /> 1 hereby certify that the above named material was delivered wi,
<br /> I hereby certify that the above named material was picked up out inck ent#o the desti[)atipn listed below.
<br /> at the generator site listed above 1^ _ l ; 7 . 9
<br /> Shipment Date Driver Signature
<br /> Delivery Date
<br /> Driver Signature
<br /> DESTINATION
<br /> i
<br /> S.r,l. Vasco Rd. landfill p.O.#02-10028 Phone No [=7:EZ1=
<br /> Site Name
<br /> 4401 Forth Vasco Road, Livermore, CA 94550
<br /> Address
<br /> aerial has been accepted and to the best of my knowledge the-1 regotng is true and accura
<br /> I hereby certify that the above named
<br /> + er •� ��
<br /> T 1
<br /> ,
<br /> Receipt 0 e
<br /> Name of Authorized Agent Si nature
<br /> a a PASS CODE
<br /> � BFi284,
<br />
|