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r Waste 0 <br /> No 729399 <br /> Systems ' <br /> BNING NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> FERRIS lHDUSTRfl:S =' <br /> GENERATOR <br /> Generator Name M.'f' F tai} Generating Location 0304 <br /> Address 19033 11_ - Ir Fziy'-M. om _ Address15 5.71 -, T ati1 _ z <br /> r <br /> r <br /> Phone No KEE] 2Z -?t 19 1 5 5 - Phone No 6 - 3 7 2 . 7 0 0 - <br /> C 4. d 5 1 1 0 5 C 0 3- '2 5 .Containers Type_ r <br /> BFI Waste Code - 5 9 D- Drum == <br /> Description of Waste Quantity Units ENo Type <br /> C-Carlon� <br /> 0 1 T B Bag AZ <br /> CGAS`7LI:�;�GZ INA' ] SOL -T Truck <br /> Tl <br /> f = rm P Pounds <br /> - Y-Yards <br /> ❑ m <br /> El <br /> 0-Other <br /> I 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 condition for transportation accords 7o epplicable'regulations -sem <br /> for Authorized Agent Name _3xr� 5+gnatUre r: �xz` ~' -L. '„shipment Date <br /> ..«y.....,r <br /> Truck No ; -"� - Phone No <br /> T' ZTransporter'Name "`°°y �` �- Driver Name (Print) �`✓ <br /> Address Z c3 lS/rt.�i'-, j Vehicle Llceni—e NoJState 9c - <br /> \ -,Vehicle CerGficarion - <br /> I hemby,cer*that the above-named material was picked up , L I hereby certify;4hal-the above_named material was delniered with- ` <br /> atthe,generator site listed hove �-+1 -- - out Incidarst to�he�destination list�dsbefow <br /> Driver SiR¢ave—~ w _ '_a 4,3 — Shipment Das• Driver Signaturn -� � w - - �-Delivery Daze <br /> DESTINATION <br /> L <br /> Site dame Phone No <br /> Addnm 7.:- <br /> 1 hereby certify that the above named mateneJ bias been accepted and to the best of my knowledge the foregoing is true and accurate <br /> MAC <br /> Fiarnerolh>4ss�prtxeG AgevA - Ssonatura Reoeiot Date <br /> PASS CODE <br /> BF1-�so-72c <br />