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Waste No. 913395 <br /> Systems TM SPECIAL WASTE MANIFEST <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS <br /> GENERATOR <br /> Generator Name �ZD"J'Aj �'� ������ Generating Location <br /> Address Address <br /> Phone No. U 3 Z ? Phone No. <br /> Containers Type <br /> BFI Waste Code <br /> Description of Waste Quantit Units No. T e D - Drum <br /> / m C- a <br /> B - Bag <br /> m T -Truck <br /> F-1 F-1 <br /> P - Pound <br /> Y -Yards <br /> ❑ m a 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 /> classi and ackaged, and ie.,in prpper condition for transportation according to applicable regulations. <br /> �( ,� e �f •-fit;':� a,(_�.��� <br /> Generator Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> Truck No. Phone No. <br /> Transporter Na e Driver Name (Print) ` <br /> Address Vehicle License No./State ���V�C/� <br /> Vehicle Certification <br /> I hereby certify that the abov ,named material was picked up I hereby Certify at the above named material was delivered wi <br /> at the generator sl Ijsted��dbove. out in_ide t to estination listed below. <br /> � F4 \ <br /> -_ W 1075�K <br /> Driver Signature Shipment Date Drivp Signatu Delivery Date <br /> DESTINATION <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 knowledge the foregoi g-ts-t ure and accura <br /> Name of Authorized Agent Signature pt <br /> PASS CODE <br /> BF126C <br /> 10/86 <br /> r,'7 Nlr-PATOP RETAIN <br />