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o,- . . <br /> 4 8 <br /> Waste <br /> . �i`1 r� NON-HAZARDOUS SPECIAL WASTE MANIFEST ` <br /> .� NN-HAZ <br /> Oilowraim rCrtFtiS 11JUUSTl7lE 5 u <br /> _ lel l---- •��F <br /> Generating Location <br /> Address <br /> �., <br /> --- -- _ . <br /> Address�---- •„ �_ _..- -- �_ <br /> Phonet10 L _ �_'i T L _. Lo. <br /> 7yt,e <br /> Phone ida �__.,__�_. - <br /> Containers <br /> _. i <br /> I� D•Dluln <br /> - L 111 <br /> ouanlit Units Nom Type <br /> r n <br /> I <br /> -- — � C-Cn1❑ <br /> L L Y _. <br /> Brl Wasle Code - 6•6ag <br /> - Q� cril),ion o,,�vzs,e ..- L 1_} <br /> --- -- T-Truck <br /> ll I� I f p_pounds <br /> L�� 1�� y_yards <br /> 4� ( <br /> O.Other <br /> ro cri described, <br /> Part 261 or any [1130cabie state law,has been P p y <br /> t �if Ural the above named material does not contain Tree liquid as defined by q0 GhR part 2E0.10 or any applica e <br /> I hereby cert y 40 CFn licnble re ulakiocs. <br /> is riot a hazardous waste as defined by g <br /> stale taw. and is in proper conditio,r for tray:sportatinr acr.osding to app <br /> classified and packaged,� <br /> � <br /> , <br /> Signature <br /> eat`I tmo <br /> Gnu��r a4ar Aulhonzad Ag , Y - <br /> Fa v tr x�i_M3`'�`.'_r tPG"31�°. (i) �����-„s•e �r7i�r...==.nuc .. <br /> 1 I Phone No. <br /> Truck No.--� <br /> (]liver Nan1c(Print)_ <br /> Transporter Name--- f r•-�--'��— <br /> Vehicle License No./State-- <br /> �Address % Vehicle Certification <br /> --- I hereby certify that the above named material eras delivered wit r <br /> hereby cern y p out incident to file destination listed below• <br /> 1 that the above named material was picked up <br /> at the generator site listed above. <br /> Shirrnent Dala Fy 770".�4;p�xi+;_31 <br /> esrvcr S qn n rB _ t C ^e.�"�r�+d'f g.4�aYt•a��T S.`t�'�-',;;�-• �'e�f ..i. <br /> S .w»...,�.�+-+-•-�"'^ 1 1 <br /> El <br /> phone No. <br /> Site Name <br /> Address_-- -- - bin is true and accurate_ <br /> knowledge the tereg g <br /> - - -- --- - --I hereby cerlify_lhat_lhe_above Warned material has been accepted and 10 the lest of mY - -- -- - - T; I - -- ---- -1 <br /> 1 <br /> - - <br /> neceipl Date <br /> Signature v <br /> PASS CODE -- 13F12G0-721) <br /> uuntl 1f_..,,,,.,.� ,nsr 1, r•r.l,-,-1?I <br />