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' Waste No. <br /> 907149 <br /> Systems TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name �1yw'J ! Uf,�inlc7 Generating Location �,Id( 79 -:v bxe4L 1461- <br /> Address Address y ~���✓ c-A <br /> Phone No. 2 U ! 2 7 `� Phone No. <br /> BFI Waste Code 1 `t O =' /7/ ,3 z O / Containers Type <br /> Description of Waste Quantit Units No. T pe D- Drum <br /> C-Carton <br /> B - Bag <br /> T -Truck <br /> m 7 P - Pounds <br /> Y -Yards <br /> F-7 Elm ❑ O-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 p aged, nd is in,properc_,idition for transportation according to applicable regulations. <br /> Generator Authorized Agent Name Signature V Shipment Date <br /> TRANSPORTER <br /> r <br /> Truck.No. lJ Phone No. <br /> Transporter Name t'//�j / �/� Driver Name (Print) <br /> Address Q3 Vehicle License No./State 7j` / L/1`O 6 <br /> i <br /> )2rt y Ir- Z ( LI 4'_ Vehicle Certification <br /> I hereby certify that the above named material v ss picked up I hereby certify that the above named material was delivered witl <br /> at the generator site listed above. out incident to the destination listed below. <br /> 0 e <br /> Driver Si ure Shipment Date Driver na ure Delivery Date <br /> IEST <br /> • <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 knowf9dge.1bB jxeg_9ing is true and accurate <br /> Name of Authorized Agent Signature eceipt Dale <br /> PVS CODE <br /> 10186 BF1260.7 <br /> _�E-I` EPATJR RETAIN <br />