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O�systems <br /> f g0-DB �Vllaste �"R�. "°. 916463 <br /> TM nI �US P CIAL WASTE MANIFEST <br /> t3RQWNING-FERRIS INDUSTAlESNO' `-H�RD <br /> GENERATOR <br /> Generator Name - <br /> r Generating Location rC' I=lrr <br /> Address Address <br /> Phone No. <br /> Phone No. �r <br /> Containers Type <br /> BFI Waste Code L LTJ D- Drum <br /> Description of Waste Quantit Units No. Type C-Carton. <br /> I C7 { B -Bag <br /> SGr W[ ckt-SA T-'truck <br /> . F1m ❑ <br /> P -Pounds <br /> Y-Yards <br /> ❑ m•❑ O-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 /> 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 co onfa ansportation according to applicable regulations. <br /> (�� <br /> BM rhGEIMMS- PT <br /> Generator Authorized Agent Name Signature .Shipment bate <br /> y TRANSPORTER <br /> Mrd <br /> Truck No/"—�` 7'. L t!, Phone No. ! '1 <br /> ' r <br /> Transporter NameSS � Jf-efrz� - Driver Name (Print) GF r f �� <br /> Address,'g CVehicle License No./State C <br /> n <br /> Vehicle Certification <br /> I hereby certify that the above named material was picked up I hereby.certify that the above named material was delivered with i <br /> at the generator site listed above. out incident to the destination listed below. <br /> i <br /> or, i-signatuW Shipment Date Dr' er nature Delivery Date j <br /> DESTINATION <br /> Site Name <br /> Phone No. <br /> Address <br /> I hereby certify that the above named material-has been accepted and to the best of my knowledge <br /> the foregoing is true and accurate. <br /> N�I a f Authorized A enE SI nature Receipt Date j <br /> - PASS CODE <br /> SF1260.720 <br /> 10186 { <br /> r 'T_ ':•. <br /> � _ UNLOADING 'AREA COPY <br />