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-Waste No 9 11 G 7 9 <br /> S]/Stn� TM <br /> ROWNING-FERRIS INDUSTRIES ES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> ienerator Name LNOCAL MarK,�-ting t c -L Sta_��ie lf3 .� <br /> Generating Location <br /> ddress P. 0. Box 5155 Address 3788 Tracv Blvd. <br /> San Ramon, Ca. 94583 Tracv, CA <br /> hone NoL5 1 0 — 2 7 7 213 6 8 Phone No <br /> FI Waste Code 0 2 0 1219 3 5 3 4 0 12 .J Containers Type <br /> Description of Waste Ouantity Units -,No T D-Drum <br /> C-Carton <br /> B- Bag <br /> Non Hazardous Soi 1m T -Truck <br /> ❑ El <br /> P - Pounds <br /> Y-Yards <br /> El El 0-Other <br /> I hereby certtty that the above named material does not contain free liquid as defined by 40 CFR Part 26010 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, <br /> classified and packaged, and is in proper condition for transportation according to applicable regulations. <br /> mo=or Authonzed Agent[Name � signature shipment Date <br /> TRANSPORTER <br /> - <br /> Lick No ' Phone No 510-634-6850 <br /> Dillard Trucking, Inc. 43 /9i� <br /> ansporter Name `� 1 1 3 <br /> Onver Name (Pant) _ _� : �J 1 7 <br /> Jdress P. 0. sox 218 Vehicle License NoJState <br /> Byon, California 94544 Vehicle Certification <br /> iereby certify that the above named matenai was picked up I hereby certify that the above named matenal was delivered with- <br /> the generator site ed above out incident to the destination listed below <br /> Iver Signature Shipment Da ature DeWay Date <br /> DESTINATION <br /> to Name B.F.I. Vasco Road Landfill Phone No 1 01— 4 4 7 0 4 19_]_l <br /> 3dress 4001 North Vasco Rd., Livermore, Ca. 4550 <br /> �Z� <br /> iereby certify that the above named material has been accepted and to the-b`est o my knows ge the f is rue and accurate <br /> Authonzed Age t S nature_ Receipt Date <br /> w � <br /> r PASS CODE <br /> so BF1260-720 <br /> TRANSPORTER RETAIN <br />