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��•.+�� �� laic=. :.�.�_--..r'. �fes.:.'_ z.�„ �... .�=lit _ .._�`k1�Y. ^.�' -- l <br /> Waste N­4.8[;1*1 %3 <br /> Systems NON-HAZARDOUS SPECIAL WASTE MANIFEST ' <br /> nnonr+r rcrtntS rr+ausrfJ+f s , <br /> Gennratinc7 Location <br /> -----.. .—�_-- <br /> Gonnrator Name <br /> „ . Address _... <br /> Address_____ --" <br /> r_ l _ 1I 1k I 1I <br /> II No. I--�r__I-! A-. 1-71 ! ] '_.�� � i Plrone No Type <br /> - - <br /> Containers Y <br /> 13FI WasteCode f__ 1- ] f----1:.._1_._.1 __.x -Tl--_]_ _l__.. _..! f_ _ I .. .I__._.L--- <br /> D•iln:nt <br /> Description of Waste C3uantily Units No. Type C_Carton <br /> - -- ._ _ _ - ------- _ _ Bag <br /> t, T-Truck <br /> � __1 Y You�ds <br /> Ell 11 <br /> O Other <br /> — ! Ileseby certify that the above Wanted material does trot contain tree liquid as dolined by -10 CFR Part 260.10 or any applicable <br /> slate late, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable slate law, has been properly described, <br /> classified and packaged. and is in proper condition for transportation according to applicable regulations, <br /> Shipri enl 011e � <br /> (CpneralOr Auq}. <br /> v!• .. ..F_....—. ..-.v,--+�.c� 2 ±...�.�`i 1� F17f1C,4•y�F. 'eh..'�s #7`3�"i.-.� `4y�'� <br /> _ - <br /> Truck No.— ----* �--�-- Phone No. <br /> —� <br /> i,. ,r 1' _ Driver Name(Print) <br /> Transporter Name — — <br /> Vehicle License No,/State ~- <br /> Address <br /> Vehicle Certification <br /> with- <br /> I hereby testily that the above named material was picked up I hereby certily that the abo a named material was delivered <br /> out incident to 113c destin`lion listed below. <br /> at the generator site listed above. <br /> ? /" - <br /> r —. ) Delivery pate . <br /> Driver Sa nature/ <br /> shipment DI J <br /> Orry r si n'JLru <br /> r ':i t' +',� ,:��v i 5�rP*y,�^"...,r._,:f.���"; .•.zu.�i-�Lw��L:� �������i' :�tl���'�i1;.�',�1T,�.3�.`,`��`��•i:�*.d�.i ?f��^,',�!' <br /> Phone No. <br /> Site Name <br /> Address --- --. �_. .------ ----- -- <br /> hereby cerhty lhaf-the shave Wanted rnalr;riat Itis been accepted and to..the..besl of my knaw[ed e rite toretgotng is true an a(_urate <br /> v - <br /> ! s ! f <br /> , 1 <br /> _,— --- naceipt Dale <br /> nalwo <br /> .lt <br /> ufruri_rc1 Art^nE _—�—._—� <br /> PASS CODE - <br /> DF12II <br /> 10 AIG <br /> f f t:^!rr.{•ftC1';rR SJt'_F/�tl! , <br /> I <br /> I <br /> J <br />