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Vlgte No. 951503 <br /> vStejje5 t>. <br /> 13 t�I�V,TgI[S NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> ��wntnn-Ft:RR <br /> • <br /> nerato ti <br /> r Nome v�'FL/vr« Generang Location <br /> dross- (-w- 1 r A L/L� Address <br /> eel <br /> D110 No. f �-�� !� $ Phone No. <br /> r'4r1111-0 ode i J G u 0 3 Containers Type <br /> Deacription of Wa61e Quantity Units No. T a-arum <br /> C-Cwtun <br /> Ela-gag <br /> T -TrucX <br /> ( Z ❑ ❑ P-fes. <br /> -Yards <br /> I hcroby cenify that the above named materiel does not contain free liquid est defined by 40 CFR Part 280.10 or Any applicable <br /> *tato low, is not a ttncmduua wosto na dafined by 40 CFR Part 201 or any applicable state law, has Leen pwperty aescflDea, <br /> classified and packaged, and is in proper condition for teansporton according to applicable regulations. <br /> �atw Avt�w•i�W AVa l Name Snrpment Date <br /> TRANSPORTER <br /> ick Na. Phone No. <br /> Inaponvr Nome - , 1 4rivr Name(Print) �J <br /> aroma +~ �=•+' s'rff r_-r '= -- _ Vehicle Uaense No.10talo -- d!2-la / 2:::z J <br /> Verlicle t'oMflcallan <br /> proby certify that the above named material woo piokod up I hereby certify that the above named material was deliverarl with.. <br /> the generator site listed abnvA, out incident to trio destination hated below, <br /> r•r Cioratrra shipmem nam FW70r SIannc%" ' D9 rv.ry owe <br /> DESTINATION <br /> e Name__ Phone I4e)tereby certify that the above named material hxs been accepted and to the bestr6f foregoing Is true and accurate. <br /> R Qsla <br /> tn�of Awlwrt:ao w ant ti�gnatur: .. ._ <br /> �M PASS CWt: <br /> � DFI20o-720 <br /> TnANsronTEn nETAIN t <br /> MCI <br />