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0 2 <br /> OSystems <br /> Waste No 7M <br /> 9ROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • <br /> Generator Name Generating Location <br /> Address T, C bo% 441-1 Address :i28 h Ben an. <br /> .'oat.t prl 35 771 <br /> Phone No Phone No <br /> BFI Waste Code x , Containers Type <br /> Description of Waste QuantityUnits No T pe D - Drum <br /> i `_ r C-Cartor <br /> ❑ 1 <br /> t L <br /> t B - Bag i <br /> ti0% HAZARDGL Sm 1:1T -Truck <br /> SOIL El <br /> P - Pound <br /> Y - Yards <br /> ❑ m ❑ O-Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 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 /> Generator Authorized Agent Name Signatuff Shipment Date <br /> TRANSPORTER <br /> Truck No Phone No <br /> l;i l la; c, T ui Arte Tric- _ -, J / <br /> Driver Name (P <br /> Transporter Name (Print) <br /> Address 0 2° ' -r Vehicle License No/State <br /> B\ ror. Cas:for t,,,t 13 ,:a-1 <br /> Vehicle Certification <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered wal <br /> at the generator site listed above out incident to the destination listed below <br /> Drier Signature ' Shipment Date Driver S+gnatdre Delivery Date <br /> t • <br /> Site Name B F I last Rnsc I �naf�1$ Phone No �— } 3 T <br /> 4001 North \asc o 1-d a' e_ i f '-1 Q- 5) <br /> Address <br /> 1 hereby certify that the above named material has been accepted and to the best of my knowledge t e forego) strue and accuratE <br /> f Authorized Agent Signature Recei t Date v <br /> PASS GODt <br /> / <br /> 10186 BF126l <br /> _ <br />