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Waste No G 516 57 Syst. gin.. OWNING-FERRIS INDUSTRIES A NON-HAZARDOUS SPECIAL WASTE MANIFEST • nerator Name �" �' L';`k�` ` Generating Location (dress P. O. Box 5 1 5 5 Address 3788 Tracv Blvd. San Ramon, Ca. 94583 Trate-, , CA lone No ' —1 1 7 2 3 1 6 1 a_ Phone No -I Waste Code c A 4 0 5 0 2 10 1 1 9 3 5 3 1, 0 2 Containers Type Description of Waste Quantity Units No T e 0- Drum C-Carton 4 1 El c T B - Bag Non Hazardous Soil ❑ �_T ElT -Truck II II II P-Pounds Y-Yards El El O-Other I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 or any applicable state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly descnbed, classified and packaged, and is in proper condition for transportation according to applicable regulations r -02 �1JlJ oc - - S«� ��_, - � e--;, i Z I c71-3 nerator Authorized Agent Name Signature Shipment Date �Y 7510-634-6850 uck No r- ^' Phone No ansporter Name Dillard Trucking, Inc. 1431/93 Driver Name (Print) Jdress P. 0. Box 218 Vehicle License NoJStat9 r - Byon, California 94544 Vehicle Certification - iereby certify that the above named matenal was picked up 1 hereby certify that the above named material was delivered with- the generator site listed above out incident to the destination listed below rver Signature "! Z Shipment pale Driver Signature Delivery Oats DESTINATION ite Name B.F.I. Vasco Road Landfill Phone No 5 1 0 — 4 4 1 7 0 4 9 l 4001 North Vasco Rd. , Livermore, Ca. 4550 ddress hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate JIM Authorized Agent Signature ' fieceiAYDate PASS CODE Yas SF1260—M TRANSPORTER RETAIN