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Waste No, 914 s 5 2� <br /> systems ,TM �.� <br /> BROWNING-FERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> GENERATOR <br /> Generator Name Dnn Lne Generating Location +� <br /> Address uS`0 E451 6„.,,t{;ho eA Address <br /> Tra cy cA _a 5.1 L� <br /> Phone No. Z b 9 g13 1,S 19 1 f 3 3 Phone No. <br /> BFI Waste Code C �l 0 v P Q i il 1 .3 3 g 3 D Containers Type <br /> Description of Waste QuantityUnits No. T pe D- Drum <br /> C-Carton <br /> Soi< R O T B - Bag <br /> T -Truck <br /> _T� El <br /> m El <br /> P -Pounds <br /> Y-Yards <br /> El <br /> Elm L1D-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 condition for tr sportation according to applicable regulations. <br /> Generator Aidhorized Agent Name Signature Shipment Date <br /> ---TRANSPORTER. <br /> Truck No. �i ��” '- f Phone No. <br /> t <br /> Transporter Name _, � i� i Driver Name (Print) <br /> Address -� 6 Q � r� _ _ Vehicle License No./State <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 <br /> at the generator site listed above. out incident to the destination listed below. <br /> Q i <br /> Driver Signature- Shipment Date Driver Signature Delivery Date ; <br /> i <br /> DESTINATION <br /> I <br /> Site Name Phone No. ! <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of m kk [edge the foregoing is true and accurate- <br /> Signature <br /> ccurate. <br /> St nature J./ tfleceiortOKr <br /> CIX <br /> PASS;-CODE <br /> 110l86 SF126072C <br /> i UNLOADING AREA COPY <br />