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j r <br /> Systems TM NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> 3ROWNING-FERRIS INDUSTRIES <br /> Generating Location <br /> GenLr Name <br /> T <br /> 450 JEAD Address SAME <br /> Address <br /> SAME• <br /> CA <br /> rPR <br /> r7 71 77 1 <br /> Phane.N0. <br /> 8 3 5 9 <br /> Phone No. l2--it]--�-� <br /> �1 Containers Type:.„ <br /> ❑� t I Z 3 3 D D.-Drum. <br /> BR Waste Code �f`J Quantity Units No. Type D . Carton <br /> Description of Waste , ❑ <br /> d { T B - Bag <br /> Sa, ` k.l �i c5c` T -Truck <br /> ❑ m ❑ P - Pounds <br /> Y -Yards <br /> 0 Q-Other <br /> e above named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable - <br /> I hereby certify that thy 40 CFR Part 261 or any applicable state law, has been properly described, <br /> state law, is not a hazardous waste as defined b <br /> roper condition for ansportation according to,applicable regulations. <br /> classified and packaged, and is in p <br /> Signature Shipment Date <br /> Generator Authorized Agent Name <br /> • <br /> Phone No. r <br />+ Truck IVO <br /> Transporter Name <br /> Jt°5 S off t Driver Name (Print <br /> Address <br /> �bYty� (1 Vehicle License No./State <br /> Vehicle Certification <br /> i <br /> ! hereby certify that the above-named material was picked up I hereby certify that the above-named material was delivered with- <br /> at the generator site listed above. r out incident to the destination listed below. <br /> (� Delivery Date <br /> i { shipment Date Dr' er Signature <br /> h l <br /> or, r signature <br /> II > � • <br /> r <br /> Phone No. <br /> Site Name <br /> j <br /> Address <br /> I hereby certify that the <br /> above named materia! has been accepted and to the-best-of my knowledge the foregoing is true arld accurate <br /> Receipt ate <br /> signature i <br /> �',+-Name nt Authorized A ent <br /> .... .- ._. .. .... . . ......,. .. PASS DE •. <br /> -- BF1260 <br /> 10!86 <br /> UNLOADING. AREA. COPY <br />