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:t <br /> Acte No. 9 10,04 3 <br /> ys <br /> terns,TM <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE., MANIFEST <br /> GENERATOR <br /> Generator Name 13ry'�t11 "k•C�1 ;��i:} Ct::[` r� 15:' Generating location <br /> i <br /> Address _ 450-E_ GEMMME�.BOM _._.. _ Address sum <br /> I <br /> TMT-Y. CA <br /> tir.fy t .�. }[ � k t�-il: S �s. s < -µ ti ,� .r t�"Kt`._ ` lS n,• �+` �]i-1C'�'J+^' ih <br /> hOn@TNO� ' `� Pt10QP iVO: <br /> � t r J �' 74 1 , <br /> BFI Waste Code <br /> A S' l D �( Z 3 S 3 v Containers Type <br /> Descri tion of Waste Quantity Units No. T e 0-Drum <br /> tt C-Carton <br /> -EE n I T B - Bag i <br /> T -Truck <br /> . ❑ m ❑ P -Pounds <br /> Y-Yards <br /> O-Other <br /> t � <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 /> classified and.packaged,.and is improperco n for r nsportation according to applicable regulations. <br /> o4 7 4? <br /> Generator Authorized Agent Name Signature f Shipment Date <br /> TRANSPORTER <br /> _ . % J_tL - <br />` Truck No. j Phone No. ����.<' ' -� - <br /> EMTransporter Name A Driver Name.(Print) <br /> Address Vehicle License No./ <br /> k Vehicle Certification <br /> 1:hereby certify.thaIt the.above-named material was picked up I hereby certify that the above named material.was delivered wit <br /> at the generator site listed above. out incid n o t des�inatian listed below. <br /> 14 1- 1 D,01k7V4ZL <br /> OaD <br /> D' q Signature- -Ship t Date Driv r Sign a Deiiv D to <br /> DESTINATION <br /> Phone No. <br /> Site Name <br /> Address <br /> .I hereby certify that.the,above named material has been accepted and.to the best of my knowledge the.foregoing is true and accurat•: <br /> •. <br /> "'�I nature . <br /> erne of Aulhodzed <br /> Agent- � " ' -' <br /> Receipt Date . <br /> PASS CODE <br /> BF1280- <br /> .. .]11188 <br /> �• ,:.. UNLOADING:AREA COPY ' <br />