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N0.4 BG _l.!_C <br /> Waste <br /> r SPECIAL WASTE MANIFEST <br /> ! teuns ,ra S <br /> NON-HAZARDOUS <br /> nnowtimC fGT1nIS ImusTmEs <br /> Genorati;:g Location <br /> S Address <br /> .,t t <br /> Address -- <br /> ----- <br /> Phone No <br /> ---- - <br /> � No._1 TYh_ <br /> e n <br /> Units <br /> BFI Waste Cade _ UL ' Cp--lC6]!:7 <br /> u, <br /> r,]iy <br /> ne <br /> ll <br /> f_ T .Truck <br /> FT `- P-founds <br /> Y-Ynuis <br /> 1 O Othor <br /> L�-i E�10 nr an a�,prvie <br /> iicabie State iavr, has been properly described. <br /> I hereby certily that the abosenallied wasle asndefineddoes <br /> by 40not <br /> CFN'nartl261 loruany app id as lined by al Ciw,Part 2G . <br /> slats law, is not a hazardo <br /> classified and packaged, and is in pruner condition for tfansportation according to applicable regulaltons. � <br /> r <br /> ---"'-- -pry nl batol <br /> // vlgll It1110 5 .,,,•tic.. p <br /> Geo Mor Av11, 111cd Ar} t MWO1 Y C-.- �' - '°sr,f <br /> J,0; <br /> iS. <br /> ve <br /> TA-9-55 <br /> ,!.,-... .� <br /> Phone No. <br /> Truck No.� �t-• _�- <br /> Driver Name(Print) <br /> Transporter Mama -.--- --- — /� ,(_3 <br /> Vehicle License No.IState---r- <br /> Address�_—.�--� _. — — — -- I/ f,��'r <br /> Vehicle Certification <br /> above named material was picked up 1 hereby eolllo5'Ihe thatthe <br /> listed below.Ijamed rial was delivered wish- <br /> I hereby certily that tha ab out incsd _ <br /> at the generator site listed above, I�t_ �� <br /> 1 l ` t' <br /> neiruty D,ta <br /> 1031� LrsWr'r�lq`at,ise <br /> 1111 <br /> UWE <br /> i]1 rr Si9natuM r ��yy -'� ' 1y:§�}�,Zw.? � v:5'ry <br /> .+t r ,ii x t � 0 1 -S� r ..V"nn. <br /> !SILT E <br /> - m phone No. <br /> Site Name <br /> true - - <br /> _... ,s l e and a curate <br /> hereby cCrltly chat fire above named inaterlal has been accepted and in the best o1 my isnot ledge.lhe..forego <br /> ---'—"�- <br /> - <br /> PASS GOOr <br /> pF12G0-72� <br /> t6iF.5 <br />