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Wash 7R, _ STEa��!�=��T <br /> f�;1�3 -HAZARDOUS SPECIAL VIA - :N <br /> NON _ 77 <br /> Bitrllr ING FERRI.",MOUSTriIE'� <br /> .""""vMnlra'qq�y � <br /> Yt=.yl....�.l..u.:w � <br /> Generating Location --- <br /> Genv;rator Name — — - <br /> Address_�.-=--- <br /> Address - <br /> . . <br /> 3 Phone No. <br /> Containers T}u" <br /> f hone tJo- _ � U-prun7 <br /> fluas7lil]� .._ Units No. Type C-caitan <br /> BFI Waste Code �—� -r <br /> Descfipt',on of Waste ,�-�—._—— TI i tl [� J L.—! 13-en9 <br /> T •Truck <br /> R.r>uunda <br /> a.� Y-Yards <br /> —� t licable <br /> _ __�---- 40 CFFf Part 260.10 or any of p. <br /> l0 CFR Part 2S1 or any applicable slate law, has been properly described, <br /> I h2Feby certify that Ilte above named material does not contcin free liquid as define y <br /> slate law, is not a hazaFdous waste as defined by rding to applicable regulations. <br /> classified and packaged,and is in proper condition far transportation accoJ / <br /> stlipment 0"10 <br /> C.r,rxia[Au so z.JA9inlrl,nm .... '4ai ,. 'Y ,i -: ''r° -r- F-J T1 •w�.ir.�� <br /> ME&�•�F6�.� <br /> t ..�'r=tY' r,�-:«:._s-.x'..r`c;�ya.r1. r':r�.-'--•------ � r .I`}Ll <br /> Phone No. <br /> Truck No. �_�_.�.-.�-.-� <br /> !';;:irr.;, Irs::• _ Dfiver Name(Print) <br /> Trarisporler Name—.r�------ j•� ?(;f �-- <br /> :, Y_ Vehicle License No./State ` <br /> Address <br /> Vehicle Certification�y------��--- <br /> I hl',reby certify that the above named material vias picked up <br /> i hereby certify that the abs'.a named material was delivered v+ith- <br /> out incident to the desG[latian listed below. <br /> at the gonermor site listed above. ( r i / f <br /> E14nr _1i�I^ r G 1 Jery ata <br /> u' - -'-"� l 4: ar Sirinaturo r <br /> } -` Shipment Ontu <br /> DrncfSittnituro .` <br /> 4 <br /> '4. !r-1 ;'M fr <br /> .vmrar�+til �i � �,-`•�s'�'- �... ��-�; �-�i�.S �•.,;�— <br /> Phone No. <br /> Sltf:Nafne f,` JU <br /> +.ddrrss �-- —.�. <br /> I h,areb'certify that the above named material has br,en accepted as'd to lho best of my knov+ledge ftte:f`drugnm�true and�curat�. <br /> J'ASS,GOOF <br /> nrIM-720 <br /> 70;fu <br /> TFtAHS`'JF1TErR f1CTAIFI <br />