Laserfiche WebLink
T 1 xN�t y1, :�F'•nrl i' <br /> 17ST <br /> a <br /> r ti/ <br /> fC.00,C WA$T$ .TO .$�''DISPOSEp <br /> s , <br /> Ues r1pC n of,, waste .,. ... .. <br /> QTS-. Bb�s . Gal Cu/fid: <br /> 5,y:y; ;FFFi•t. - •1 x .4 , year gl.-ayps,= B99Flas ami .PrP.Cecti,ve lothing <br /> :.This' is -to -certify that, the above:uamed <br /> .o *4terials:are oiler ::�c3as$�Lfied,. <br /> r Si ture,of of Agent; (Date) <br /> 4�" <br /> F i. �} i <br /> �'Y �'1Rl�DT&PQ }r ", ' <br /> r :, e4 a i` <br /> " , sr, �o, ;INC4RPQ ,ATED ,SOB; NO..I��Q�� ,UNIT: N0. <br /> _ a- <br /> 7' A, �,la,gas �►vRnue; Pitk�Up.;Date �, .' Time <br /> mi <br /> ?IIf <br /> r 1 f w " )Fl �IE)'i' s . This' form,<:is tai be used in-:lleu:oY the,m: ., <br /> U N,y ti 4'i3u. �k•e,�,^S.r 41..�i,,Y ` ;`} a - 4 I ` <br /> Department =of..Reailth ;Services <br /> y g ardous <br /> Waste:Nan feet for NOH--H AOUS <br /> y _• $I�._ i�x Authgrired;iAgeut . TASTES only. <br /> Vw <br /> ry� — — <br /> ISPOSAL FACILITY' 1. <br /> J <br /> oivedI; . Bela Gal /Yd Tons _..__. <br /> � <br /> :LL <br /> DYSPc�SeL<MTHUD <br /> y f; urtac4a,'7[apc►u 4 +st►c .�� Siguuture AC.A,uthorized. Aganti (Date) <br /> KX UKN cOeY TO <br /> .,9TAMQL1 iNU. <br /> P1100 'Box i 5u <br /> WAN MARTIN, Cil. �504f5 <br />