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IN <br /> aerI mss- zu a..�d. x�taar <br /> Waste <br /> ' <br /> systems <br /> DOUS SPECIAL WASTE MANIFEST <br /> ,~:sw <br /> NON-HAZARDOUS <br /> t3el0YltJltlG-FLR1115 UEUUSTftIGS t t •� ���� '.>f.•������ ,�, } <br /> -,1- •" -t �;:. +y,,t.. r��7,-,...... �...-++41:..-r�S_...-±+--�- i'.t 3''w, "'_" t. t _.��` 't �ft_�___---.._._ -._..,. <br /> ..r- <br /> t Generating l_Oc alien_ ----- <br /> Generatljr , <br /> gddress <br /> �'u__E] phone Na IL _ Type <br /> Audress <br /> --�.�-�-1 _. - Cie Rld411T?Y5 <br /> phono Na. �u- - - j C Cnnn <br /> - Clual111ty_ f_ Units N�_.-. 'Type a[to,l <br /> - ` g.pag <br /> HFI Waste Code ---�__ _.._..___�-- - u� . <br /> Description oi_W�stf� _-- ' <br /> P-pounds <br /> Y Yards <br /> FO 0 <br /> uu applicable <br /> r_- ----- 40 CFR part 260.10 or any es <br /> ro ell described, <br /> part 2fii or any applicable state law, has been p P y <br /> hereby certify that the above named material does �oC-Rlain tree liquid as defined <br /> regulations. <br /> state law, is not a hazardous waste as delined by <br /> state lied and packaged,and is in proper conrdition for transparlation according <br /> A'' Sj,ij)rjjen1 M1113 <br /> /r '' —" S;gnaSu,o y i;4acC s 3"N sXii fa.:+ <br /> ,:.�F"`'•� <br /> Geuel Olur Autharixad 9 t ,.•fn, f_.... <br /> -4. ;'rjll <br /> L[r ,3 tj1`. .._-,_i-.y,�y,+,W„n�''��,.:. �EiF•�S_,>s, ltt i <br /> Phone No._ <br /> Truck No. Driver Name(Printj , f <br /> 1'!x1; : ' ---, �r, r�ri ( �,• <br /> Transporter Name----------- Vehicle Licenso No-lstate�-u <br /> Address • t; =r `°l"%' r �. <br /> Vehicle certification U'"' <br /> y I hereby certify that tile above na fisted geloawas delivered with- <br /> 44erial <br /> cerin that the above named material was picked uP out incident to the d <br /> I hereby <br /> a,-t_.r__s_te sed ab-ov-e`• <br /> at the generry <br /> e;tn <br /> _ i ` B Lv�u <br /> � ��r��E� X5.57' �� � 'Y•i <br /> OYiver 119n11w0 <br /> { G .]�Y.;-µJ.r a S.rr',�i p,-4Se.'P J',�wa:.. t,.,,'s, - `-' �f-"._. I,' •'� <br /> Y S <br /> _ Phone No. <br /> I,j <br /> Site NW110 is _-------_-�^.- <br /> _�Y. knowledge the loregoing is true and accurate. <br /> Address----------- <br /> - ---- - <br /> - - - -- <br /> Ihereby certify that the above flamed material has liceri accepted and to the best o ` - <br /> flaraip�l e11a <br /> tJ>r�al Aulhoiirc`•A<)�nE__ r--=�=�.�==---�_� <br /> PASS CODE- - -�--" nf1269-720 <br /> 10109 .il,n,rir-r„-,lilt-f• <br />