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yri°sa- +f9} : ii' :fi'S`!�3`'^!'r c %-3"a�n9 1� ;: --m:�:a :a . <br />•°l A.'£.. .ti1�.TT a 'm :A k ! lT-.._ f E' Y!' -l i9'�'� "R'�Ltv_ _ d.. !. 'Sv}k""J< .t' - , <br /> S <br /> �- rl„ ���3 q�;.1 7 T <br /> systWaste <br /> + rns - SPECIAL WASTE MANIFEST <br /> N-I IAZA�D�US 771 <br /> nttavrtnru;.rrnnis rnvvsTrries �� ,..�....,�.f,.,...lr.�-.-,�� °��^""�""�'"""""'�" <br /> , GPnec,ting Cor,:;slun __ _- <br /> Address <br /> Addross <br /> r <br /> 4 tI lI I 1t { <br /> No. t ..._i _1_ .1—L_ S�1_ Phonn No. l --- <br /> r hone Conti ver., <br /> yp <br /> __ D-Drum <br /> Bit Waste Code -_ -. ` I' _ - Quant+ty Ultits tJo. €yf,o C.Carton <br /> _ _ <br /> Descrlptten of Waste _._ __ I p-C1ag <br /> L <br /> _. . _ T •Truck <br /> p Pounds <br /> Y-Yards <br /> O Othor <br /> licable <br /> I tserehy certify that the abnve named material does not conlairs free liquid as derived by 417 CPf3 Part 260.10 or any app <br /> Slate law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable slale law, has been properly described, <br /> classified and packaged,and is in proper condition for transpofint�on according to applicable regulations. <br /> Srg rn4mc / 1 1 � <br /> U ncrilCr Au, 1 U Ac7 ink td'tnrn �'— x••5:1 .,rr.wvsr': ,�.ci;•la', Zr.¢'d�:•, 4'�3' i�q ' <br /> �-- Phone No, <br /> Trunk No. <br /> , I': =: .1 I,,I, �t''0=• — Driver Name(Print) <br /> Transporter Name _i_" <br /> Vehicle License No./Sate 1 <br /> Address_ <br /> Vehicle Cerlirication <br /> 1 ,crab certify that the above named material tvas picked up— I hereby certify that the abrne named material was delivered with- <br /> y out incident to the destination listed below. <br /> at the generator site listedIabove- —TE <br /> [� <br /> I e:rvery Darn LJ <br /> L�. �--- Nver sigrtawru <br /> $h pmco,❑a1n <br /> Srgn�lu![, -+--,rr�t-qTr�--e^r' i <br /> 14 <br /> Phone No. L-_l r J <br /> Site Nnn,r —.._...__._._. <br /> Address ---- <br /> -- <br />__... <br /> y certif y that tt <br /> he above male,ia,has beemaccepted-and <br /> €hereby to..flte..br t o€my knowledge the tare oin +s rue , 1 <br /> PASS cQDr `— <br /> ©r12.G(1 720 <br /> sn;or, <br /> II,�Arlr;lirlr+lrr? Il[:t�Irl <br />