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Waste No - : n <br /> �I <br /> Systems 7M <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • <br /> Generator Name Generating Location <br /> Address P �( Address 312£' h Reniami t Holt Dr <br /> iic ,i�1 - Ott x>_O': <br /> Phone No Phone No <br /> __ I ` I ' Containers Type <br /> BFI Waste Code <br /> Description of Waste QuantityUnits No Type Drum <br /> _ 1 F El � O- Gartor <br /> 71 B Gag <br /> NO , I;a[ u: . ` TTruck <br /> soli 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 1s in proper condition for transportation according to applicable regulations <br /> GPrrU brrAa-�-L., - V 12 KAL-1- <br /> Gen ator Authorized Agent Name Signature Shipment Date <br /> ;'_0--634-.,150 <br /> Truck No Phone No L jf J <br /> Transporter Name Driver Name (Print) <br /> Address F 'D ' " ' Vehicle License No/State <br /> B,iG ' C E J. <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 w& <br /> at the generator site listed above out incident to the destination Itsted below <br /> Driver Signature Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> Site Name Phone No EEE= <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of my knowiedge,the foregoing is true and accuratE <br /> IN of Authonzed A ent Signature Receipt Date <br /> PASS CODE <br /> 10186 BF-126 <br />