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r Paste No.4 V G 3 OIL <br /> ", = WASTE MANIFEST <br /> ����e�� NON-HA�ARDC�US SPECIAL _ <br /> nFtr}YJtI1Nr; ttRIS INDUSTME <br /> rL <br /> e a..> he,'i` �' <br /> MY <br /> lit c s r.r, i�,L1 tt <br /> „ . Generating LocationCcneratUr Name---- -------- . .,.,,. <br /> Address <br /> Address-_.�_'----- -_ ---•� rt.c,l�+ci. <br /> Phone No.=21 <br /> Phone No. �.1 �[�r -"-��—�—�} Containers Typo <br /> Q <br /> NoT e- Arum <br /> puantit Units . C-Carton <br /> E3F!Waste Code — Des Criplian of Waste <br /> B 4319 <br /> T-Truck <br /> I'_.i 11 P-Pounds <br /> y.Yards <br /> �� ❑ <br /> o.Other <br /> —'-� <br /> 44 CFFI part 260.70 or any applicable <br /> {icable state law, has been property described, <br /> I hereby Certify that the above named material does not contain tree liquid as define Y <br /> Slate law, is not a hazardous waste as defned by 40 CFR Part or any app <br /> classified and packaged,and is in proper condition for transportation ion according to applicable regulations. <br /> / <br /> ;'.y d—�SL - <br /> t <br /> Gen•=z:or Aog nl NatnnShipi-neril Date <br /> ? i d <br /> t1loli7 d AOff-`t:= i , <br /> Phone No. _ <br /> Truck No. <br /> ii 1): tc :-rt0, In Driver Name <br /> Transporter Name t , <br /> Vehicle License No./State - <br /> Address } > 1 <br /> Vehicle Certification <br /> hereby certify that the above named material was delivered with- <br /> I hereby certify that the above named inateflat was picked up out incident to the destination listed below. <br /> at the generator site listed above. <br /> r. ! <br /> C�} � DolivarY DaSu <br /> Driver Signature <br /> _ �-Shipmant Data <br /> _ ver <br /> Dnvcr Sgn�luse I ) � _.r,4 <br /> M <br /> } y. rr i�n' Yd a�sFy�`.ta K G. .. ..�•y,s -iwa ^.-;-`. . <br /> �• + r1 1, i-L Phone No. : <br /> silo Name • ' a{) <br /> "{)l11 1.'qC! `f .-,-:w <br /> -- -- - ----- -- -- --Address_ - - - - --- <br /> I hereby certify that the above named material has been accepted and to the best of my knOviledge the foregoing is true an accurate <br /> ZV <br /> neCei t Dale <br /> �� tl'mo of Au�hcli.ed A4rnl _ . <br /> PASS CODE <br /> IIF126°-726 <br /> TRANSPORTER RETAIN <br />