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Waste <br /> } , = systemsTM SPECIAL WASTE MANIFEST <br /> NON-HAZARDOUS <br /> O 1 '�-HAZARDOUS <br /> 13110Y1N1NG F"111S I110U5FR1E5 p y �- - + <br /> 7 a 4 z t".�< - <br /> 7. <br /> Generating Location_�-�— <br /> Gerleralor �-- <',1!Z. I t,, .s I•.: ,._,� t��_-- <br /> Address-- ---�- <br /> Address�_�.�__._.�i-`-j- Ir J c,,.. • <br /> ffiL <br /> _ ! ] �26 <br /> Phone No. L�- ContainersUD <br /> Phone No. I T pe <br /> --1� Units No• <br /> Big <br /> Quar'lil El �� <br /> Bf-I Waste Code Description of Waste -- L_.-1-�a Ba g <br /> tlf )ODD= ❑ L__tl—J <br /> :..- <br /> 40 CFR Part 260.10 or any applicable <br /> ---- property described, <br /> a ticable stale law, has been p p y <br /> I hereby certify that the above named material d°e h0°GFR Part i261 toruZ y J Pdpefinedttc bie regulations. <br /> condition for transporlatlon according t°app <br /> state law, is not a hazardous waste as defined y <br /> and packaged,and is in proper <br /> classified P EE <br /> StupmewC�do <br /> A. <br /> L <br /> � <br /> _ phone NO. � { <br /> Truck NO, ""� <br /> Driver Name(Print) <br /> Transporter Name <br /> r•ITi.F.LLi ^i.ra:r!alr�-� ).1':C. — �� � � ( <br /> _ Vehicle License No./State <br /> Addresst.rz s, / <br /> 1 t V:1,�<<t , .Y: _ Vehicle Certification <br /> -----�� —� 1 hereby certify tnat the above named material was delivered with <br /> icked up.. <br /> I hereby out incident to the destination listed below. <br /> certify that the above named material was p <br /> {er�erator <br /> slfi to above. <br /> at the J .l //rc`( J <br /> J , fl [. Cr UOIiV©ry <br /> f !H I L� ate Grlvor SiUnaturo <br /> 5ltipmunl <br /> EM a <br /> ,or-ilgnalura <br /> O <br /> �i F - i t ) <br /> :t e, lj <br /> cr':: -, " <br /> Phone No .l =, <br /> Site NarTle '- <br /> i_L:Pk,A iC,[t I' [U 4i• Trl�c 1 r.>}1 r is <br /> and aCCUrale. <br /> - - -- - - - -- Address— -- -- --- ---- --- -- <br /> knowledge <br /> the foregoing <br /> r ) <br /> I hereby certify that the above named material has been accepted and to the-best o m / <br /> ., y Recooaso <br /> sib__ -----� <br /> ------------ <br /> - <br /> PASS GODF <br /> s°;ec <br /> 'IRIINSP0T3Sfrl-�t�ITAITJ <br />