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tvc -I VO. 1.1 U1LLHr 11!_. -1. Ua43L'1�lYJk7 NO. ' 950f ,( <br /> F cr 1iCC`YYJ , 1r, <br /> JNON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> :1 <br /> Ganrratutg ;..oCanon , <br /> ass. i '�`ff-•�' ra/, r <br /> 'rte— <br /> ' Phone No. <br /> CSD <br /> Containers <br /> .� f I ContainersType <br /> Desn „ton a Waste Quantity Units No. Tyyypppeee D•Drum <br /> G o f j o C•Carton <br /> 7-Truck <br /> P•Pounds <br /> Y•Yards <br /> mO.Other <br /> ro;;eby.ac:'y that the abc:e rar„ed rrzto;%al toes not contain 'ree ;iquid as dc-tined by 40.CFS Part 260.10 or any applicable <br /> i!s;a ;aw, s .iot a hazardC,.s :taste as 4:lef1rzd by 40 CPR Part 261 Or any applicable state law, has been property described, <br /> c_ec.oif:e.Z an_ pac�agatl, 7n.o s 1n pro;er condition for transportation•according to applicable regulations. <br /> � \,., � ..fir• •..,• -f'r..G �+r"%� /(~ .1i ir�r ry vr. - / � © r} / it ' <br /> Ac:aonz.-„'.A%W^«:4:5 $i$P.EtXb $hpmiN Dile . <br /> tlnylC� ' rK�Sia�� �+ •t • � <br /> T:uck No. Phone No. 41/ ( 0 <br /> fart. ” J/� n Driver Name(Print) <br /> C e_s_ ' Vehicle License NoJ8tate C k.> 7 J <br /> • - 'fir' t - .,i t �`,� :`.': i.,un.� `, . <br /> Vehicle Certification <br /> ;:aby certif :^at She 2bCve rmfned material was picked up I hereby certify that the above named material was delivered with- <br /> _. out incident to the destination listed below. <br /> y /r <br /> :'.:FMS:Du, Driver slgnutura l ' Delivery Date <br /> • ... - _.. . . .. - .q....••y,,.. T,..,-£tea.. <br /> a.re:., L6r:", :;.z: tr,< G zo•:e na^oc :~,zt<_>isi ;h&-, been accapted and to the best of m�knowledge�oing is true and accurate. <br /> - y <br /> A6:oiot Data <br /> r <br /> PASS CODE <br /> Ft t-:r AIM <br />