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077 <br /> ' � ` `ster <br /> NON-HAZARDOUS SrcCf�li� WASTE MANIFEST <br /> CRov.,mN,4 FEFP.is mrouSTRIES <br /> Generating Location <br /> ' f <br /> Address / r ✓ _ .' Address S FO t/,'T&Al < A. — <br /> -:.r,a l•::�;'..,�;� `/-' Luh <br /> Phone No. Lam— ' r Pion No. FTT7 <br /> SFI Waste Code '_!_1 L!_1_,—I 17T Containers. Type <br /> Description of Waste Quantity Units No. Ty" <br /> 0-Drum <br /> In <br /> C-Carton <br /> ! T n �.. . ��' u 8 Sag <br /> LJ m T .Truck <br /> . ! P -Pashas;. <br /> Y-Yards. <br /> O.Other <br /> i hereby certify that the atove nameo matenai 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 datined 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 /> u. <br /> I 1 <br /> - 1-7 <br /> . <br /> 3411eratcr AwhcnzaC Agent Noma S;gna u.e shpmtrnt Dttw <br /> Track No. a ---— Phone Na. h 8S O <br /> Trars..crer Name '�"•' "..,. '`'' __ Driver Nams (Print) fl, 40 Zv'4 -4/Z 0 -n-�f <br /> 1 <br /> Address Vehicle License No./State Ngo a 6 <br /> Vehicle Certification <br /> I rsa eoy certify that the above named material was picked up 1 hereby certify that the above named material was defivered with- <br /> at,ho_zneratct sire fisted Erre. G out incident <br /> `ttof thedestinationlisted below. �s <br /> sntpmanl Owe Drivor Signature Delivery Dore <br /> . .. Rte--." •t+ ^•'n•� ..�.rryprryr fir_: gg <br /> Phone No. ��'�S.�y�- <br /> �—Ii I I <br /> I her3by certi;y that the aco•.e m imad material has been aecepled and to the bqLokowl he'orf egoing is true and accurate. <br /> lv;:•'e 01 AOAM'aaa Agen• _— g! rt,+„prp xua Date <br /> PASS CODE <br /> t...t,I=G •1°' REG,,,. <br />