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PUBLIC NON-HAZARDOU <br />"FE&L WASTE & ASBESTOS MANIFEST <br />Fs <br />869846 If waste Is asbestos waste, complete Sections I I.- U 1� <br />I� <br />.ndr <br />It waste lb NOT asbestos waste, complete sections 1, 11, <br />GENERATOR Kgenaratnr romnlMniz Ita-A i <br />PA ID Number <br />c. Responsible Agency Name and Address: <br />d. Phone: <br />b.Number. <br />i Name and <br />CER71FWATWNI I hereby declare #%O N* conte -to a(#*�oohs%pWap* are tufty and accurately desorkpid above by the Proper ShkONIM"I <br />ind am ciewoW, paduge4 marked and labolelecarded, and are In &M respecix in properconditionfor transport 00&0(*Wffu <br />V 60 acablO int9ttlOrml andradormi OMWWWWW" reatimbw <br />e. f3enerat MaEr-19 <br />ICU A.AO*A <br />S1— <br />afflelf1f, sycek- CA, <br />N.., P- <br />CIS <br />PI'me: SAN 6AAC-15CD qq,10 <br />.. -C-V it <br />CON <br />g. CA <br />If OWW Of the genera ng FaClITY aftrS Ir -OM the generator, provide: <br />h. Owner's Name: <br />I. Owners Phone No,: <br />1. Waste Proft # <br />k. EV. <br />Data <br />1, Waste Shipping N*ne and <br />ely <br />n. Total <br />o. Unit <br />Description <br />NO. <br />' TvDe <br />quentjty <br />Wt(Vol <br />30 <br />'Y <br />=Va*M.w =two' <br />Y40 261 or any jqVilib" <br />nnmeO MaWW Mtat hPairdoto wasle as da*W 0 4 <br />by <br />art pro <br />vid It In proper oond*n'fcw timraportatibn aocordliig to applicable regulatkx* AND, If thils, <br />wigio to a trawrlaq residue of a- wm* a*d to the Land Disposal Restrictions,I cw* and warrant that the waste hiLs <br />beenh "10 -in of <br />and Is no jgtW a hazardous W�vs defined by 40 CFR 261'. <br />644A <br />Aullilagm-d Amd kh-k-fa <br />r. Date <br />POW i 10 3— Q <br />And Destination Sita mrnnintes- <br />b-0) <br />AYIA "r <br />"k Aft 0% Re N le <br />IV_ AARFSTOS <br />L Operator's Nam and Address: <br />b. Phone: <br />c. Responsible Agency Name and Address: <br />d. Phone: <br />4.3p@MHmN* Instructions and Additional Infbi vim 01 RIF <br />Lj F"abla S. NMI"" <br />CER71FWATWNI I hereby declare #%O N* conte -to a(#*�oohs%pWap* are tufty and accurately desorkpid above by the Proper ShkONIM"I <br />ind am ciewoW, paduge4 marked and labolelecarded, and are In &M respecix in properconditionfor transport 00&0(*Wffu <br />V 60 acablO int9ttlOrml andradormi OMWWWWW" reatimbw <br />10padw 11ft 10 nywI*Mow9,IA— Opwall","ob swer4ft" ft or to denW@Wn <br />15 , �cft bAV ftoWW or MWIVA11014,or <br />or <br />J 7- <br />swirl, <br />11111MROWTAr <br />CON <br />�!M <br />IV_ AARFSTOS <br />L Operator's Nam and Address: <br />b. Phone: <br />c. Responsible Agency Name and Address: <br />d. Phone: <br />4.3p@MHmN* Instructions and Additional Infbi vim 01 RIF <br />Lj F"abla S. NMI"" <br />CER71FWATWNI I hereby declare #%O N* conte -to a(#*�oohs%pWap* are tufty and accurately desorkpid above by the Proper ShkONIM"I <br />ind am ciewoW, paduge4 marked and labolelecarded, and are In &M respecix in properconditionfor transport 00&0(*Wffu <br />V 60 acablO int9ttlOrml andradormi OMWWWWW" reatimbw <br />10padw 11ft 10 nywI*Mow9,IA— Opwall","ob swer4ft" ft or to denW@Wn <br />15 , �cft bAV ftoWW or MWIVA11014,or <br />or <br />REV 1W10 VENERATOR AET01RS-NIA <br />.7 <br />