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tai j�•�;;,,.� �•A � tNo, � r <br /> G^OWNiNG-;eRFlS 1NDUSTP.',S NON-HAZARDOUS SPECIAL - AS THE MANIFEST <br /> .",.. w.T. .. <br /> 373 <br /> - - Canwarir:g Location — — <br /> i <br /> rtFt A/ CIA Address <br /> Ohon6 No i I u� ( I —1 Phons.No. <br /> 3P4 `^juste Cc,:9 i Containers Type <br /> Description of Waste Quant it Units No. TvDq D-Drum <br /> © r t C-Carton <br /> B-Beg <br /> (�pNS7 ru7%on: ja�n.� L ur.{Cr ❑ m T-Truck <br /> P-Pounds <br /> Y-Yards <br /> - r -. :- ''r.� -' ` � m ❑ O-Other <br /> I hereby certify that the stove namea material does not contam free liquid as defined by 40 CPR Part 260.10 of any appiicaole <br /> state taw, is not a hazardous waste as defined by 40 CPR Patt 231 or any applicable statelaw, has been properly descrioea, <br /> classified and packagad, and is in proper condihcn foi transportation according to applicabie regulations. <br /> Gara:a:cr A.!'^ td AW!NaMe SY,nature SNpment Oats <br /> Truck No. i 2 t.. ; . !�Ae S� T 0 <br /> Phone No � <br /> Transpwtar Name r ' -! ', �C%'?-:.�4 Driver Name (Print) f/1�W.L1 <br /> Ad'rrss Vehicle License No.tState 1/t'n Z. -7!l <br /> -- - VehicleCertHication <br /> i !.^rewy ce!ify that the above name-: m:aer!zl was ;.irked up I hereby certify that the above named material was delivered with- <br /> at tho g6rercicr site iistaj 2tcve. oat incident:o the destination listed below. <br /> _.$�qn uta Stdpn•.}nt Date Dn.or S natura <br /> �9 r� Ouiiv»ry Data <br /> Cita Nams Phone No. i 1_j—i I i I <br /> hMby:3rfi•r tRat trte 4t4ova naried materia! has been accepted and to the best of my knowledge the foregping is true and accurate. <br /> 13r <br /> r airs c'Ru:nwaaC ASt.: 9,4nmsr� i" rtattnt Dmu _ <br /> V' <br /> PASS COD2 <br />