Laserfiche WebLink
Waste : ^ r <br /> No <br /> t <br /> Systems TM <br /> BMING-FERAL INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name Generating Location <br /> Address t t t - Address i L - <br /> Phone No t} } Phone No <br /> f3Fl Waste Code ' ' Containers Type <br /> Description of Waste Quantity Units No Type D-B - BaCart <br /> C - e <br /> ❑ g <br /> ag <br /> T -Truck <br /> 5D1r <br /> ❑ � P -Poum <br /> Y -Yard, <br /> F-1 El -Othe, <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 /> t � 9 r <br /> G for Authorized Agent Name Signat a Shipment Date <br /> - TRANSPORTER �j <br /> Truck No �"� � /'�, Phone No <br /> Da 11a, ( '_ c r _-it inc z K <br /> Transporter Name Driver Name (Print) <br /> P 0 Bc% 213 <br /> Address Vehicle License No/State w <br /> Bxrotl Catifo. 'la 94514 <br /> Vehicle Certification ')'o y 3 'I o 4 z_ <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered wit <br /> at the generator site listed above out incident to the destination listed below <br /> / 0 <br /> 70 <br /> �D 6,�,ZM Fn <br /> Driver Signature Shipment Date Driver Signature Detrvery Date <br /> DESTINATION <br /> B f I %OSco P,_I I <br /> Site Name a,, Phone No 'df7I1 - 1 — <br /> 400 'north \as, - n^ f,3,%.er;ni <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of my knows dge.t a foregoing is true and accurat( <br /> F!+tame of Authorized Age rit Si nature / ReGei t Dale <br /> i <br /> PASS CODE <br /> 10186 BF12( <br />