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`nr r <br /> ■rite--.- No. <br /> 916001 <br /> =M <br /> Systems <br /> ]BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL.,WASTE MANIFEST <br /> GENERATOR <br /> ; r <br /> Generator Name DGME PLO IUM C'!Ml� Generating Location <br /> Address 450 E. GRAr�'TLM R= Address SAME 4Y <br /> TPAC'Y, M 95376 SAME <br /> Phone No. 2 0 9 —18 -3 5 9 1 3 3 Phone No. 2 0 9 — 8 3 5 9 1 3 3 <br /> Containers Type <br /> BFI Waste Code C s 4 0 f 3 3 3 G D- Drum <br /> i ( <br /> Description of Waste Quantic Units No- T Pe. C-Carton <br /> Sa l u.f �iaSe� <br /> FYI - Bag <br /> El I I;l T-Tsuck <br /> F-1P -Pounds - <br /> Y -Yards <br /> E m El0-Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 280.10 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 in proper condition f ransportation according to applicable regulations. <br /> ` <br /> II <br /> BOB FAGIMES PLVU MANP� l.� Q cra ` o Z 6 `� Z- <br /> ,Generator Authorized Agent Name Signature Shipment Date <br /> - TRANSPORTER <br /> . I <br /> Truck No. Phone No. <br /> . e <br /> 7. Transporter Name ZerhliletZeLic�ehse�NalTSta!t/e <br /> Address T Vehicle I <br /> Certification <br /> 1 hereby certify that the above named material was picked up I hereby certify thaf the above named material was delivered with- <br /> at-the generator si fistedab e. out incident to the destination listed below. } <br /> 6 / <br /> Driver ur <br /> ^� Shipment Date D' ignature Delivery Date <br /> DESTINATION <br /> mi <br /> Site Name ' Phone No. <br /> Address <br /> I hereby certify that the above named mate al has been accepted and to the best of my knowledge the fore Ding is true and accurate. <br /> _ <br /> Receipt Date <br /> of Authorized Agent Si nature <br /> PASS CODE <br /> 9F1260-720 <br /> 10!86 { <br /> 0 <br /> ''UNLOADING AREA COPY <br />