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10AprNORTHSTAR Non-Hazardous Waste Date: a41z6r21 <br /> ©� ENVIRONMENTAL CROUP,INC. Client#: 10207984 <br /> �i Manifest Document#: 104971 <br /> WASTE ORIG IN <br /> Section I. <br /> Origin Location: FedEx Ground-5655 Hood Wax Tracy CA Phone: 209,839.2050(updated:3/24/2021) <br /> Address: 5655 Hood Way <br /> City: Tracy State: CA Zip: 95377 <br /> Section II. <br /> Description Number of containers Type of Container Qty Units <br /> Grit Trap Waste 1 T 216 Gallons <br /> Description N.-her of containers Type of Container Qty Units <br /> Description Number ofcontainers Type of Container Qty Units <br /> Section III.Special Handling Instructions <br /> Section IV.Generator Certification <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Pall 260.10(sails)or any applicable state law,is not a hazardous waste as defined by 40 <br /> CFR Part 261 or any applicable state law,has been properly described,classified and packaged,and is in proper condition for transportation according to applicable regulations. <br /> Customer Name: Jennifer whitlock Signature; <br /> Section V. <br /> Name of Co.: Northstar Environmental Group,Inc. Phone: (800)449-7504 <br /> Address: 417 N.Blythe Sheet-Gallatin,TN 37066 <br /> Driver: Richard Burke _ <br /> Receipt of Material(Driver's Signature): Date: 04126/21 <br /> DLSTINATION <br /> Section VI. <br /> Disposal Site: Profile#; <br /> Address: City: <br /> State: Zip; <br /> Signature: / Date: <br /> Section VII.Special Notes <br />