Laserfiche WebLink
�AIaSt@ No. 950775 <br /> SySt@mS To NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> t3RDYYNICrO.fE�S�NUSTRIES <br /> GENERATOR <br /> Generator Name-Sil-r;A rA n e,'f.,7.. —� .� Generating location�L:, 7 Z <br /> Address 7 :1: ) E A ,—, r.I Z) f (J ' • Address 5 i;aTt r < A <br /> 'AAJ <br /> Phone No. =—❑ Phone No. <br /> BFI Waste Code ❑ ❑� Containers Type <br /> Descri tion of Waste Ouantity units No. T D.Drum <br /> ❑ a <br /> � ❑ C-csaangon� �- - <br /> ❑�❑ ❑ ❑ ❑ ruck <br /> P-TPouds <br /> Y-Yards <br /> L�L�I—❑ Elm 1:1o-Other <br /> 1 hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260.10 or any applicable <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law, has been properly described, <br /> classified and packaged, and is in proper condition for transportation according to applicable regulations. <br /> Generates Addarized/µ7m1 Name S' <br /> 5nazun Shipment DW <br /> TRANSPORTER <br /> Truck No. i ! ?l O phOne No. ;/o - y—3-/_ t S J <br /> f <br /> ,Transporter Name nilly'h Tit JL r Driver Name(Print) / r ✓' r/_ A <br /> AddreseoQ+ nae J/Sr P-iVi'-).-r A Vehicle License NodState J R(1 J -2 <br /> Vehicle Certification 7 i <br /> I hereby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> at the generator site listed above. out incident to the destination listed below. <br /> A <br /> DrMer Signature Shipment pale Driver Signazuie OeMry Otle <br /> DESTINATION <br /> Site Name Phone No. �❑—� <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoin Is true and accurate. <br /> " 2 <br /> Name o7 Authorized Agent signature neceid pale <br /> PASS CODE <br /> 10M . , BRNO-79e <br /> GENERATOR RETAIN <br />