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06/21/2085 17:22 931363 4 SHANNON DOWNS PAGE 02 <br /> 50103 <br /> TENNESSEE GENERAL CONKRUCTION, IMC. - ENVIRONMENTAL DIVISION <br /> 150 Robertson Hollow Road - Pulaski,TN 38478 • (931) 3635379 • www.tngeneral.com <br /> NON-HAZARDOUS WASTE MANIFEST <br /> EMERGENCY PHONE NUMBERS: (931) 703-5379 ► (931)309-AS43 <br /> GENERATOR INFORMATION <br /> Business Name- . ,f&;1A C. � Zf2[L?5`^ - WO�►: y©(i "?O - 1 <br /> Address���I �fi��r-} ot►t rte- 146d <br /> City: _ �Q State C Q Zip 3 1 B(e(0 Phone:e�0�- 9 9J <br /> Waste From 01W1S: Grease Trap: Grit Trap Other: <br /> I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE,THE WASTE MATERIAL REMOVED FROM THE ABOVE <br /> PREMISES CONTAINS NO HAZARDOUS MATERIALS. <br /> (Pease Pring <br /> Dati servi6w Time In <br /> COMMENTS: <br /> TRANSPORTER INFORMATION <br /> Transporter Bualness Name: TENNESSEE GENERAL_CONSTRUCTION, IK' <br /> Addres8 150 ROBERTSON HQLL M ROAD <br /> City. PULASKI- State _TN____ Zip 30478 Phone: 931-363-5379 <br /> Gallons Racalvad: <br /> 1 CERTIFY THAT THE INFORMATION PROVIDED ASOVE IS CORRE AND THAT ONLY THE TYPE WASTE SPECIFIED <br /> IS CONTAINED IN THE SERVICING VEHICLE. <br /> DftIVRR N (Plww Print) <br /> 0&4 S cod Tlme Out <br /> DISPOSAL INFORMATION <br /> Businm Name: <br /> Address <br /> City: arses zip <br /> — <br /> Gallons Fscslvod; <br /> Date Waste Rawivbd Disposal SM Opmahoes Signature <br /> Rejected: (Explain) Accepted: ❑ <br />