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N0N.I4AZ4RL,,flS SPECIAL WASTE &,.SBESTOS MANIFEST <br /> o(- It waste is asbestos waste complete Sections I It ITi and IV No. 907904 <br /> It waste is rNQT_asbestos waste Complete only Sections 1 It and HI <br /> Selwi ? GENERATOR tGener.mr tpmpiet"as et sea-4 <br /> t Generator Name L\I ut COMD UOI I - >• b Generating Location r ,a t I t I it, - -7 +> <br /> �n71 �as�ice' T;s1L';liititwr tftatln ,; ualttt zui� 61, r <br /> Address d Address <br /> HouaLon T% 77--:2-213( t )-1 Oft -A <br /> 3 Phone No <br /> 17 131 6136-77,61 1 Phone No <br /> I owner of the generating faality differs from the generator provide <br /> 3 Owners Name F\,yn Coinpdn% L h Owners Phone No "tu '` - <br /> TYPE <br /> BFI WASTE CODE I O 0 I ,1 13 1 1 p ^, 7Containers DM METAL DRUM <br /> DP PLASTIC DRUM <br /> 8 BAG <br /> I Description of Waste tioit 11RZnt Lttstl- 4u 1 ' k Quantity umts No TYPE SA 6 MIL PLASTIC BAG <br /> J fl 31 0 <br /> S( MIT <br /> ID T TRUCK <br /> D OTHER or WRAP <br /> GENERATORS CERTIFICATION a hereby certlfy that the above named matenal is not a hazardous waste as defined by 40 GFR Part 261 or UNITS <br /> any applicable state law has been properly described classified and packaged and min proper Condition for transportation according to P POUNDS <br /> applicants regulations AND It the waste Is a treatment residue of a Previously restricted hazardous waste subject to the land 01sposal Y YARDS <br /> Restrictions I cantly,and warrant that the waste has been treated in accordance with the requirements of 40 CFR Part 2aa and is no longer a M' CUBIC METERS <br /> hazardous waste as defined by 40 CFR Part 261 ,s� ti-Le tiSC On t Ern Y3 CUBIC YARDS <br /> _ � Q OTHER <br /> J,Al �LrL�J -r r2, f 1 1 r� f <br /> Generator Authorized Ago Name Ci5 IT" -r - Shipment Date <br /> r:..C M r 4 y I/ /�w.r'I t- , .J <br /> Tranepoder] Q <br /> SectlDri II �- TRANSPORTER t3eneremrcwnoletaa.d Tia n hit <br /> TRANSPORTERI TRANSPORTERII <br /> Dillard Ti ttcking lite <br /> a Name h Name <br /> P 4 Bvx 218 <br /> b Address I Address <br /> Bvrou 4 9014 <br /> c Dnver Na Ttle 7 (AJ 15 F e f f f 1^ / ; Driver NametTide <br /> Pf ir] +50 PRrNTnVPE r PRINTRYPE <br /> No a Truck No f k Phone No I Truck No <br /> e <br /> cle License Nojstate _{ 1 m Vehicle License NoJState <br /> Acknowledgement of Receipt of Materials Acknowledgement of Receipt of Materials <br /> g �T n <br /> prrrer yrs <br /> Ship—m Date 0hve,Slqmwm chi men,Date <br /> SeCGI DESTINATION (Generator COrtlpkfa3 a-d de'dCnatkln alta COfnple-04) <br /> a Site Name <br /> BFI 'vastra Rd Lalltfti1 c Phone No 43101 447-011,1 <br /> b Physical Address <br /> 1001 Noi tit %AkCa ftutud Mailing Address <br /> t 4001 Not I h lot n Pt"set <br /> LiVatuwrr C% n4550 LSLr+talus 1 X1;;4 <br /> e 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 /> JOB* 2002 68 <br /> f NlmedAWonredAGrl spun a RewiptDate POs 00-20104 <br /> Section IV. ASBESTOS (Genii for as f aparewr cdrt,Qwc.s e) <br /> a Operators'Name b Operator's'Phone No <br /> c OperatoYs'Address <br /> d Special Handling instructions and additional information <br /> OPERATOR S CERTIFICATION I hereby`declare"I the contents of this canstgrn wd aro fully and aCoundely described above by P POPer ShAPPnng r>eme and are classified ' <br /> packed marked and labeled and are In all respects in proper condition for transport by highway according to applicable International and government regulations <br /> e Operator's Name&riitte <br /> PnnUFype ppe w s sgnawro Date <br /> f Name and Address <br /> of Responsible Agency <br /> g ❑ Friable ❑ Non friable ❑ Both %friable %nonfnable <br /> Orator refers to the company which owns leases operates controls or supervises the facility being demolished or renovated or the demolition or renovation operation er both <br /> REORDER ONLY THROUGH BFI 1 UARCO CONTRACT TRANSPORTER RETAIN 260-7208 srs3 <br />