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- Na. 916011 � <br /> systems TM. <br /> BROWNING-FERRIS INDUSTRIES" NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Geerator Name <br /> Generating Location <br /> Address 450 E. GRANmii�t-E F IAD Address SAME } <br /> t <br /> TRA=- , M 95376 <br /> rr �� l� <br /> :phone _No? `2 � 9-, -S 3 5. 9 '`I .' 3 3 Phone No.' 2 0.. ;9 <br /> i BFI Waste Code C d S O cf Z 'S �j i��t7� Containers Type E <br /> Description of WasteQuantic Units No. T pe D - Drum <br /> S4 — : w 1.4 (JiOsn l <br /> C. <br /> Carton <br /> ! ( B.'Bag <br /> T -Truck f <br /> P - Pounds � <br /> Y -Yards i <br /> ❑ m ❑ O.Other � <br /> . I <br /> 1 hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable <br /> i state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, <br /> 3 classified and packaged, and is in proper condition f7ransportation according to applicable regulations. <br /> ZBC�B FAGUNDFS, PIAL ( l A)A <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TFUNSt <br /> • • <br /> Truck No. 4 Phone No. <br />' 'transporter Name Driver Name (Print) <br /> Address Vehicle License No./State V`����5!'d •_„ <br /> i. Vehicle Certification ZQ_g,7/_ Z <br /> I hereby certif that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the generator Re listed above. out incidentlisted below. <br /> 1Z I e g <br /> nature Shipment Date Driver Si Delivery Date <br /> DESTINATIOM <br /> Site Name. Phone No. <br />. Address <br /> I hereby certify that the above'-named material has been accepted and to the best of owl dge the foregoing is true and accurate. <br />`. <br /> Ni', Authorized Agent Signature eCeipt a1 <br /> PASS CODE <br /> 40!86 • • BF1260-720 t <br /> UNLOADING AREA COPY , :. <br />