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l w6 <br /> n;;��S' <br /> t .i No. k i <br /> TM, 916028 <br /> BROWNING-FERR[ INDUSTRIES' NON-HAZARDOUS SPECIAL WASTE <br /> MANIFEST <br /> I <br /> Generator Name CYST ZTTT Generating Location <br /> i <br /> Address <br /> Address _ <br /> Phone No. 9111i 13 1 5 19, 11 1 Phone No. L 13 1 Ig <br /> BFI Waste Code C D S 1 D { EZ 3H3 ; O Containers Type <br /> Description of Waste Quantity Units No. Type D - Drum <br /> { C-Carton <br /> Soi� +y/� �ioSe 1 R 0 8 Bag <br /> m � T -Truck <br /> P -Pounds <br /> _V?3-,.., Y-Yards <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 /> 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 conditi n fort sportation according to applicable regulations. <br /> BOB FAGUNDES PLANT NIANAGM J G�r 0 Z G i7 <br /> Generator Authorized Agent Name Signature Shipment Date <br /> dilk <br /> TRANSPORTER , t <br />; i <br /> Truck No. L;� Phone No. <br /> Transporter Name ro L e x., W. Driver Name (Print) f L <br /> Address Vehicle License No./State r U <br /> Vehicle Certification <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered witl- <br /> at the generator site listed above. out in 'dent to the destination listed below. <br /> Driver Signature Shipment,Dale Driver SiqlarGre Delivery Date <br /> DESTINATIOW <br /> Site Name Phone No. �— <br /> Address. <br /> I hereby,certify that the above named material has been accepted and to the best of my kr)Owledge the foregoing is true and,accurate. <br /> ' e of Authorized A ent � „g, lure Receipt Date <br /> g S! na <br /> PASS CODE <br /> 10/86 <br /> BFi260-72L <br /> UNLOADING AREA COkPY <br />