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Waste— No <br /> PI -90G047- -- _ <br /> - Acct tba 1 [1(I�tC�z2—'-__ _ _ <br /> OSystems TM <br />(BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> ,GENERA • <br />(Generator Name t�!id Cal t_easlny G�atin�gLoca�non1 543 E _ Chinn?i 5t <br /> I <br /> Address P C Box 55103 Address Stockton , Ga w <br /> I <br /> ��o�Iii=nr� ra . 95?0F <br />(Phone No 2 4 9 — _ 5 3 6 Phone No �— <br /> BFI Waste Code- A [ Q 9 F1 1 2 ? 7 5 Containers Type <br /> Description of Waste Quantity Units No Type D - Drum <br /> C - Carton <br /> Diesel Con tarn i noted Soil ' p Fil m FT] B - Bag <br /> T - Truck <br /> ❑ �� ❑ <br /> P - Pounds <br /> Y - Yards <br /> ❑ m ❑ 4- Other I <br /> i <br /> I 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 /> Iclassified and packaged, and is in proper condition foF ir-ansportation according to applicable regulatsons <br />.Generator Authorized Agent Name Signature \" Shipment Date <br /> Fa`s ="'t .J � .,a,}''�S Hifi :•a unyr` (7 `R 9m ,�+..� � a �t ���� tlyA�`A�y,;� ,^ ,iF" <br /> ruck No Phone No <br /> Transporter Name I`9 o Erav� anrr:entan Services, Driver Name (Print) ►�5 ._ r ` � <br /> ddress -'nnrt t=1�t�on ;meat �� _ � <br /> - Vehicle License No /State �� � �� o�� <br /> Vehicle Certification <br /> hereby cert4y that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> it the generator site listed above out incident to the destination listed below <br /> Enver Signature Shipment Date Dn a Signature Defivery Dale <br /> l <br /> Y <br /> o � s <br /> 31te Name /'=co Phone No FT TL _ <br /> dress 1001 VaTc'=' Ro�ct L7 verm-r q 550 <br />�ereby certify that the above named material has beer accepted and to the best of my knowledge the foregoing is true and accurate <br /> f Aulhonzed A ent Si nature Receipt€]ata <br /> PASS CODE <br /> 1 OF"1260 720 <br /> GES' -RATOR RETAIL <br />