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Waste No. 915950 <br /> Y TM <br /> Ste <br /> BROWNING-FERRIS IIES NON-HAZARDOUS .SPECIAL WASTE MANIFEST <br /> Y <br /> GENERATOR <br /> Generator Name C'N, 11 7� rGenerating Location <br /> Address 450 E_ GR== BADAddress SAME <br /># SAME <br /> Phone No. ��. Phone No. 2 0 9 8 3 3 3 <br /> BFI Waste Code 0 S I I I 1 0 { Z 3 3 Containers . Type. <br /> Description of Waste Quantity Units No. T pe D -Drum <br /> ` C-Carton <br /> S9i1 �i("t gln�e, i b t B -Bag } <br /> T -Truck:. <br /> Elm E <br /> P -Pounds <br /> =- Y -Yards <br /> FT <br /> El F1O-Other. <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 /> tate 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 in proper condition ;4nsportation according to applicabt� regulations. <br /> Generator Authorized Agent Name Signature Shipment Data <br /> Truck No. 1`S PhoneNo. – <br /> Transporter Name Driver Name (Print) <br /> i <br /> Address Vehicle License No./State – 2 <br /> c e Certificati <br /> I hereby certjfy that the above-named material was picked up rher.4 hat the bove named material was delivered with- <br /> at the generator isted above. a destin tion listed below. <br /> D er Signa Shipment Date Driver atur vary Dale <br /> DESTINATION <br /> Site Name Phone No. �— <br /> Address <br /> 1 hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate. <br /> i <br /> N.� �4Authorized Agent Signature Receipt Date <br /> PASS CODE <br /> SF1260-720 <br /> 10!86 � <br /> UNLOADING AREA COPY <br />