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�s <br /> NON-KAZARL-,US SPECIAL WASTE $,-113ESTOS MANIFEST <br /> if waste is asbestos waste complete Sections 111 [i[and IV NO. 907901 <br /> r If waste is N.Qj asbestos waste complete only Sections I t[and III <br /> "" GENERATOR (Generator completes as of Soctlen q <br /> eratorName TT L' \u21 Couptan L � A b Generating Location �c un St-tit ,,, r t7^ <br /> 0b6,t213ht�jim �spsglndtiuis �tiJai„ <br /> c Address d Address 'Tt�� tin r t+ I iib S I t I <br /> Hoq�ton T", <br /> 77252-2180 �turktott it <br /> e Phone No 171:3) 656-"7g1 t Phone No <br /> if owner of the generating factilty differs from the generator provide <br /> g Owners Name E �or. <br /> 'i.uot nti, t _ A h Owners Phone No Same is 7St <br /> I BFI WASTE CODE '1 I I (] ) ! t , „ 1 , <br /> Conlalners DM METALL DRUM <br /> DP PLASTIC DRUM <br /> i <br /> Description of Waste hair Ha z t t 1+u- Sot ' B BAG <br /> k nU111EE10 <br /> Units No TYPE BA 6 MIL PLASTIC BAG <br /> or WRAP <br /> T TRUCK <br /> OTHER <br /> GENERATORS CERTIFICATION 1 hereby cemty that the above named material is not a hazardous waste as defined by 40 CFR Pan 261 or UNITES <br /> arty applkxble state law has been property descnbed classilled and packaged and is in proper condition for transportation according to P POUNDS <br /> appikable regulations AND,If tine wants is a treatment residue of a previously rostricted hazardous waste sublect to the Land pisposal <br /> Restdetlons J certify and warrant that the waste has been treated in accordance with the Y YARDS <br /> hazardous waste as defined by 40 GFR Part 261 i requirements of 44 CFR Part 266 and is no longer a M' CUBIC METERS <br /> Y' CUBIC YARDS <br /> JA AAE el ' O OTHER <br /> Generator Airthorized Agent Name TS "atrl`e�i F r, i Shipment Dees <br /> All <br /> SeChOn 11 TRANSPORTER Gaerator oomplete a.d T=na'r it=0etaatUri <br /> TRANSPORTERI TRANSPORTER}I <br /> a Name J11Iia1 I] T ue k.1a l J1e <br /> y-Narr� <br /> b Address P J iiv� 218 <br /> i Address -. <br /> c Driver NamelTitlec �v cam_ l Driver Name/Tide ^ <br /> PRJNTmPE PRIIYTrVPE <br /> d Phone No a Truck No �it I k Phone Not <br /> --�-- , I Track No,. <br /> f e License NoJState Syl S..SE-- m Vehicle License NOJState <br /> wledgement of Receipt of Materials Acknowledgement of Receipt of Materials <br /> Drrvar tura n <br /> Bhlprrmt Data DMer Wra Shi t Deter <br /> Seet}On H1 DESTINATION (Generator eompietea R4 destination alta completes e-1) <br /> a Site Name HFI Vasco Rei Landfill f13101 44-1-0191. <br /> c ?hone No <br /> Physical Address 4001 ,rurtl, l ib( J kucid 4001 North Var ,I`u Ru<tcl <br /> d Mailing Address <br /> Livermuc, i , 9J;;i1 <br /> Ltvt <br /> r Discrepancy Indication Space <br /> I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> JOBB 2002 ,a <br /> slwmtu. P09 Il <br /> Repiq Dara .9-«D}J I <br /> lection IV ASBESTOS (Generator mmpWo e-d f g operator•oofriplatae s) , <br /> i Operators Name b Operator's Phone No <br /> Operators*Address <br /> Special Handling Instructions and additional information <br /> 7PERATO"CERTIFICATION J hereby declare that the contents of this consignment are fully and accurately described above by proper shipping name and are dassrfied <br /> acked marked and labeled and are in all respects in proper condition for transport by highway according to applicable international and government regulations <br /> Operators Name&Title <br /> PnnVrypa <br /> Name and Address Dparelora sgnewra Dasa <br /> of Responsible Agency <br /> ❑ Friable E] Non friable ❑ Both _ %friable %nonfnable <br /> i o <br /> Operator raters to the company which owns leases operates controls or supervises the lactl_7being demolished or renovated or the demolition or renovation operation or both <br />*XLY THROUGH BFI/UARCO CONTRACT <br /> TRANSPORTER RETAIN ® zeo-7soes+sa <br />