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ystems s. NON—HAZARDOUS SPECIAL WASTE MANIFEST 1 <br /> ROWNING-FERRIS INDUSTRIES <br /> GENERATOR <br /> ► �tf <br /> generator Name �� PwI7[JJC�S �� Generating Location r <br /> address 450 E. GpJaIM N E ROAD Address <br /> SAME <br /> TPACy, C2k 95376 SAME <br /> 3 <br /> 8 3 5 9 1 3 3 Phone No. 8 3. 5 .'9 1 3. 3EEE <br /> hone No. Containers70rum <br /> y b s q 9 o I z 3 8 3 3 0 <br /> BFl Waste Code <br /> Description of Waste Ouantit Units No. Type K <br /> �o:` — �• + �1�Sa` T -Truck <br /> F1 � ❑ P - Pounds <br /> E:El= Y -Yards <br /> O Other <br /> E== <br /> m _ <br /> I hereby certify that the above named licable stat6 law, has been properly described <br /> material does not contain free liquid as defined by 40 CFR Part 260:10.or any applicable <br /> �st4te law, is not a hazardous waste as defined by 40-CFR Part 261 or any app <br /> ; <br /> �lassfied and packaged, and is ire proper con 'tion fo ransportation according to applicable regulations. <br /> Q 0 <br /> FAQ r PLANS MAMGER_ Shipment Date <br /> Generator 1,uthorized Agent Name signature <br /> EM <br /> G5 9 <br /> '2Gb Phone No. _ , <br /> Truck No. <br /> Transporter Name <br /> !4 L /.� Driver Name (Print) _ ,ffcJc'f t <br /> Vehicle License NoJState t'X� f S <br /> -Address ��2'`� <br /> Vehicle Certification <br /> that the I hereby c that the above named material was picked up I here idcnt to the destination listed below.IT ve named ria! was delivered with- <br /> at the ge era or site erti <br /> listed above. out <br /> Shipment Date war Signature <br /> O Delivery Data <br /> Driver Signature ' <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 accurate. <br /> Receipt Date <br /> Nr f ^rof Authorized A ent <br /> Si nature <br /> PASS CODE <br /> • • BF1260-720 <br /> 10!86 • <br /> • ' • UNLOADING'AEA COPY <br /> R <br />