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o No. 916014 <br /> Systems T. <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST ' <br /> GENERATOR <br /> 'Ge ator Name ;+n,, P T_�)'. r nr.:v <br /> Generating Location <br /> Address Address ; <br /> SAME <br /> Phone Na: Phone No. TF; 3 5 9 1 3 3 <br /> BFI Waste Code C Q 5 i O 3 G 3 ; Containers Type <br /> I Description of Waste Quantity Units No. T pe D- Drum <br /> se, a.i � It t nSe\ c Carton <br /> u B- Bag <br /> m Fy <br /> T -Truck I <br /> P - Pounds <br /> Y -Yards <br />�• ❑ m <br /> F-11 O-Other <br /> I hereby certify that the above named material-does not contain tree liquid as defined by 40 C�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 is in proper condition for tr;�Spo <br /> rtation accordin to a 1 <br /> , g,. pp�icable regulations. <br /> �a — u�r� . ► o F <br /> Generator Authorized Agent[Name RIAM Signature Shipment Date 1 <br /> TRANSPORTEFU <br /> s <br /> Truck N0,2�, <br /> Phone No. <br /> ' <br /> Transporter Name�� f C 1,�C Z. -:,- Driver Name (Priv � <br /> Address r/ r 00-n C Vehicle License o./State <br /> r <br /> t� <br /> Vehicle Certification j <br /> hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> h. <br /> at the generator site listed above, out incident to the destination listed below. <br /> o 9 <br /> Q ► <br /> Dr' er Signature Shipment Date. Dr' er Signature Delivery Date <br /> DESTINATIOM <br /> Site Name Phone No. <br /> Address / <br /> hereby certify that the.above named material has been accepted and to the best of my know,! / 1,,<i._•;. <br /> Nam- 'Authorized Agent Signature <br /> 10186 I� <br />.- •.. IE 'UNLOADING:AREA r <br />