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Waste <br /> l No — r <br /> Systems TM ` <br />(OWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br />?neratorName f_NOCAL `farket-,ig 4(� �,. 5tat�on 163,3 <br /> Generating Location <br />(dress P. 0. Sox 5155 Address 3788 Tracv Blvd. <br /> Sart Ramon, Ca. 9+.583 Trac} , CA <br /> one No 5 1 0 7 % Z 3 6 8 <br /> Phone Na <br /> I Waste Code C A 0 2 1 0 2 9 3 5 3 4 0 2 Containers Type <br /> Description of Waste Quant,,. D - Drum <br /> Units Na T <br /> E EE <br /> e <br /> T C-Catton <br /> (Von Hazardous Soil 8 -Bag <br /> T -Truck <br /> 0 = 7P oun-PPounds <br /> Y-Yards <br /> El== ❑ ❑ O-Other <br /> I hereby certify that the above Warned material does not contain fide liquid as defined by AO CFR Part 26Q �0 or any applicable <br /> 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 /> ��r <br /> �AgentcO ZO 3calor AunhorizName Signature <br /> Shy Date <br /> TRANSPORTER <br /> k No 510-634-6850 <br /> Phone No <br /> spotter Name Dillard Trucking. Inc. 1431/93 / <br /> Driver Name (Print) L . <br /> ess P- 0. Box 218 Vehicle License NoJState 3 �^ <br /> Byon. California 94544 <br /> Vehicle Certification <br /> 3014_� <br /> sby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> 3 generator site listed above out incident to the destmatlan listed below. <br /> 1 � <br /> Signature <br /> Shipment Dat• D Signature Delivery Date <br /> IM <br /> DESTINATION <br /> Jame -B-F.I. Vasco Road Landfill - 5 ( 0 4 4 7 4 9 1 <br /> Phone No. 0 <br /> ass 4001 Horth Vasco Rd.. Livermore.-=Ca. 4550 <br /> by certify that the above named material has been accepted and to the best f my kn I e the torso-ing is true and accurate. <br /> f ed A ent <br /> Signature <br /> Receipt Data <br /> 4 i <br /> � S <br /> I <br /> PASS CODE <br /> 8F1260.720 <br /> TRANSPORTER RETAIN <br />