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' ,, W ZAR US SPECIAL WASTE "BESTOS MANIFEST <br /> If waste Is aQ1 asbestos <br /> complete Sections t LL til and a <br /> No. 907633 <br /> It waste is dQT asbestos waste complete only Sections! 6 and ill <br /> a GENERATOR (Generator comPtafas au of ss"""n <br /> Ir' i lltii, t it t Al = ; <br /> a. Generator Name��rrtt �`t'Lou Coml2sppnv C S 1 b GeneratingLocabon <br /> a Address <br /> PEINn218�as�to �Ge�i Rat ui, ,1c«it, d Address gout:Fiti �'ittl I"11 I <br /> Houston T` <br /> 772112-213, 't Of 1-is C <br /> e Phone No <br /> 17131 656-7761 f Phone No <br /> If owner of the generating facility differs from the generator provide <br /> !.: � 1 Sats C 1� I I N <br /> g Owners Name E�"uIl t uB¢4R" h Owners Phone No �E <br /> Containers LBA <br /> METAL DRUM <br /> i BFI WASTE CODE PLASTIC DRUM <br /> BAG <br /> �rou Ila,u t duiin `E,+ i k Quanti Univ No TYPE 6 MIL.PLASTIC BAG <br /> Description of Waste or WRAP <br /> TRU <br /> GENERATOR$CERTIFICATION t hereby certify that the above named rll�tenal is not a hazardous waste as dehned try 40 GFR Part 251 or UNITS <br /> arty applicable state law has been property described ciaaslfied and packaged and is in proper condition for transportation according to P POUNDS <br /> ous waste subject to the <br /> ap�regulationssl rtify�ANDarl h the waste has beenrlssidue reated=nf8 previously restricted accordance with the reCuiremenntts of 40 CFR part m one is oCiong a M' CU8 C METERS <br /> hazardous waste as defined by 40 Crant FRPart261 VJ_ t11e LLytt ai Di L • it t l�asntitl+. I Y' CUBIC YARDS <br /> � O OTHER <br /> J'q,nEY <br /> I Generator ADthonzi.tl Age erne shipment Date- aril t� ✓ fn /ti�N77'1 L <br /> 4 TransPorlsr 1 dtirrtplate a.g <br /> Section II TRANSPORTER Gensrator complete a c Trans r n tiom to Urn <br /> TRANSPORTER II <br /> TRANSPORTER! <br /> Diliatd Ttucf.ilrtz t' h Name <br /> a Name <br /> P O O U L -'t o Address <br /> b Address <br /> 'cr t ..l i ~Drlvar Name�tle <br /> c Driver NameMbe PRirrrrrvPE <br /> (5101 634-685f) PRINTRYPE I Truck No <br /> e Truck No k Phone No <br /> d Phone No <br /> .#'' m Vehicle License NoJSlate <br /> f Vehicle Ucense NodState �;�_ Acknowledgement of Receipt of Materials <br /> Acknowledgement of Receipt of Materials <br /> �(n }v C t� T n sn t Date <br /> 9 Sri Brie Dau odv.r si <br /> Diiv.r uu+ <br /> SeCtorr III, QE5TlNATIQN (Generator compfetea a d deatlnasort eke rnmPteles 1 <br /> BFI t',s:tca (id i✓-ur.ICli " t'tlnl 117-t1�4J1 <br /> c Phone No <br /> a. Site Name 4401 tut tit 1:t ri r rr ii <br /> 40'51 "W i to V t t;J a ��ui d Mailing Address <br /> b Physical Address <br /> L1,.,,-Latillu CA iri I—) <br /> e Discrepancy Indication Space <br /> I hereby certify that the above named materiel has been accepted and to the bast of my knowledge the foregoing is true and accurate <br /> -- =25 <br /> a JUII$ 2002 6R <br /> 4 p4= CJ-204D 1 <br /> I fsipnamis R00691 DateHama d,4,itimxed Agent <br /> Section N' ASBESTOS (Generator oomplst)a-d f,g Operator vmpleTes e) <br /> b Operators Phone No <br /> a operators*Name <br /> c Operatoes-Address <br /> d Special Handling Instructions and additional information <br /> OPERATOR'S CERTIFICATION 1 hereby declare that the contents of this consignment are fully and accurately descnbed above by proper shipping Hams and are class+hed <br /> 4 proper oandihon for transport by highway according to applicahis international and government ragulall ss <br /> packed merited and labeled and are+n all respeClS m <br /> 4 -�-'--� <br /> S e Operators Name&Title vopa.forasp+riswr. <br /> �rivrvp. <br /> 1 Name and Address « <br /> of Responstb4e Agency <br /> g ❑ Friable ❑ Non Enable ❑ Both <br /> o triable o nontnable <br /> Operator rioters to the company which awns leases operates controls or supervises the facility being demolished or renovated or the demolition or renovation operation or both <br /> k 4 2867208 ys7 <br /> I REORDER ONLY THROUGR HFI!OARCO CONTRACT TRANSPORTER RETAIN _ -- <br /> 1 <br />