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Cda.4 8 q <br /> waste <br /> } . . steles 'r.' NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> Df1UV111111C�FGftnIS IIJDUSTPICS <br /> Gnnelali„q Lecalion __- - <br /> - -� <br /> Gennrator 1`1,11110' <br /> Address----- -- <br /> Address --- — - — ---——'= <br /> --- � f Plronu Ido. <br /> phone NO, <br /> T YJ,e <br /> fl-U <br /> ��1 t_ T 1 l _ l31 - Otlantily <br /> Units No. " TytJe <br /> C' r't9 ` <br /> RN tTJaslr!Grtde <br /> F — - B-t7a <br /> pescrm of was1r'_ =— <br /> _ -- -- T -Truck <br /> POLIMS <br /> Y Yards <br /> O.Other <br /> 40 CFR Pari 260.1Gro erl described, <br /> ��— <br /> or at <br /> 13d <br /> �' 40 CFR Part 2.G1 or any applicable s;rle law, has been p p Y <br /> 1 hereby certify lltal to above named materia;dogs not contain Lee liquid aseicabl y regulations- <br /> is <br /> law,is not a hazardous wasle as deline�by <br /> packaged, and is ilt proper condition for iranspertat;on accordingtD appli able regi <br /> Classified and p. I 1 f l� <br /> } 1 L <br /> / ,✓ rI ��_Ste!_[ t"r'f r :�r r` -r'r_� _ _ Shipment Dat <br /> ��,or.iSor Auitwntnd A9enl Na,ne „�,! _ M 9 '' <br /> Phone No. <br /> Truck Na. " — <br /> ,: : Driver Name!Print)��•--�— <br /> "Transporter Name -- <br /> Vehicle License No.lState�/_ <br /> Address r--���5- --.. , , rf•�; /�__�--� '~~ <br /> ' r " Vehicle certification. <br /> above a named material was picked up t hereby certify that the above named material was delivered vritlt- <br /> J hereby cerf,fy that the out incident to the destination listed below. <br /> ator, iletl;at the gen�l $led//`above. EF-ID <br /> FID <br /> — <br /> Roto <br /> / •!` /f - Driver ci9na!urn <br /> StsipmrvnlDtle ..•R <br /> — Mp�., _ <br /> D:ivcr 5iynasure .., .Tn,;j y_LS .;7 <br /> Phone No-01-0- <br /> Site Name -- t r <br /> _..:is.l i '.•-! ;, `': ` `•„ i'-'•: �-_��...�_ - -�--•�— <br /> Address —— —��—— � oln is true and accurate. <br /> the above named material l,as been accepted artd to the best of my knovrledge She lofe9 g <br /> - - -- - <br /> herahy certify lhai <br /> f'�_ .----•—� neCeiµS Daley_ <br /> ---`--�.._ -- -– PASS CODE <br /> art<earzo <br /> sores <br />