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t t �;anyon Coen Butte Ir?Ox mo, untain '-"Newby Island Forwam <br /> -San <br /> id ry Landfill Landfill <br /> Spnitary La dfiff S : ry Landfill Landfill <br /> 12310 <br /> c � q�,4C2 S f <br /> Half pay. C"A klyP%3� CA CA <br /> POrM f6,"x,€j 728-151r_ !e�6t ��iM°i F t�^e �¢;� fig;ten' <br /> Fax g 4 # 3 '.� .?, ��',;z , a , a r� Fax t6sn) 7,?& 1 3 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> r,ENE �._..__ �. __.__._ - <br /> _._.,._. _.,.__ WASTE ACCEPTANCE NO, <br /> M ILING ADMSS <br /> ..._ i <br /> CITY, STATE, ZIP <br /> PHCN _W. .._ _., aL�. stk a Cs.a ,`.; � ? I !IA ) E o f <br /> "J ­ <br /> TV-K -`�AFE`�Y VEST <br /> G{ N ACT PFPSO,Rv <br /> f4ANr?i_ING FROG DIJES. <br /> SIGNATURE OF A 13 HOR(ZED A FNT TITLE IJATE <br /> 1 <br /> - <br /> es> 40,fk the ::Favre is a Sr®a4ar�;�3',!re,Sas eTf 3t gac�y�i�istt p ens§ry�6&sd�enxars�cru>�swa�4a <br /> WASTE TYPE <br /> ,i.. <br /> JSPECtA7 '&AST€: ..__........_._.._.... _. .. .._� _.._.....-- -.__.__.. .._ _.....__...__.._ <br /> -- .......... <br /> .e oDy ExiW _ � <br /> TRANSPORTER ._ ..... , - r aE- TRUCK NUMBER <br /> _... .. .... <br /> _._ <br /> DDRESS <br /> ..........._........... .. <br /> P ik EtFL L)tJP,IP BOTTOTA DUMP TRA�ISFEFi <br /> r�. y ------- <br /> _j <br /> alw lATUR( v AEaT¢��)Fa31f�} A T�) ? D i[��ER I�1T C LJ,° E� 71 F LAf-§iE� Oaf J � I)�U10S <br /> .T— __-.....__..... _.. ..._ _ _ ...... _� .„T..�_..,... .. .._._... ....._. <br /> .,.3 _j _j <br /> 3 r^y <br /> a C6JB,'(', t APDS <br /> I hereby certify that the above named Material has been <br /> a <br /> accepted 9 foregoing <br /> tiand t� $h� best �f rxt knowledge� tf�e ar <br /> is true and accurate. <br /> DISPOSE OTHER <br /> ------------ <br /> - <br /> FiEI��l� IES <br /> j t o is ea L fti)fi <br /> i <br /> E TO <br /> S€GGA FTE O F AU a��OR� ��f �; Jai <br /> _ ._._...._.........._. - <br /> i <br /> 9 t <br /> ..__.......�.;.�....�_....._..... ,; .�-,_,.,__,_ _.__..�. -.�_..._...._ ..._.......__.._._L_. W-d SNS CSA OTHE,P ... <br /> mEOULING MUST B FE MADE PRIOR �;t�€3�.�4mTfl�I��� I�FYt$' � i� 7 ��f��lllF I»•�N[�'�I� f� ���LbAD A� t���l�� ,. <br /> T REFUSAL UPOR APR OIDAILY DELIVERIES MUST BESCHEDULED WITH THE LANO ILL THE PAY FOROL' <br />