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1 - - <br /> Wash AFI Acct FJri_ tCr43C342 No 906020 <br /> Systems TM NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> BROWNING-FERRIS INDUSTRIES <br /> GENERATOR <br /> Generator Name +4t l d f a t t_ecis-ii,g Generating Location <br /> r dress 5,,A b5 103 Address S,t(7)c I VOli , Ca <br /> -)r1 , Ca 952 0,-,- <br /> gone No 0 g —fl i 5 -a - 5_ r `l 1 I Phone No LJ <br /> I Waste Code ` 4 5 U f Containers Type <br /> Descnptlon of Waste Quantity Units No Tvpe D - Drum <br /> C -Carton <br /> r, iC ,l I Guiilait. iiioued S o 1 1 R m B - Bag <br /> T Truck <br /> ❑ m ❑ P - Pounds <br /> Y - Yards <br /> ❑ m ❑ O-Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260W10 or any applicable <br />' state law is not a hazardous waste as defined by 40 �FR Part 261 or any applicable state law, has been properly described, <br /> classified and packaged, and is in proper condition for(tr�nsportat n ccordig to applicable regulations <br /> ld K R I neh Ar t Dill I li 91 <br /> enjaialor Authorized Agent Name Signature Shipment Date <br /> w � <br /> ruck No l 1? Phone No � l 6 660 3 j 1 6 <br /> Iransporter Name r i�r��11F1i r.t Q i =` , �- Driver Name (Print) ✓ ft .__ <br /> ddress 1 t i ��""`''r '"' `r Vehicle License No IState2S 2 Z 5 Y I - I U 9 9 U D � <br /> k <br /> Certi <br /> Vehicle ation <br /> f <br /> 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 II out incident to the destination listed below <br /> Ofivor Slgnaiwu Shipmeni Date Driver Signature Delivery Date <br /> DESTINATION <br /> rrte Name _ .0 Phone No i <br /> ddress I C C) Ft C)a 6 L 1 v c,i n <br /> i <br /> fl hereby certify that the above named mateital has been accepted and to the best of my a ge the foregoing Is trite and accurate <br /> IIII <br /> of Auihonzed Agent Signature Receipt Date <br /> I <br /> PASS CODE <br /> E <br /> 10186 BF1260 720 <br /> UNLOADING AREA COPY <br /> I <br /> i <br />