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PVMING-F <br /> Waste No 1067851 <br /> SystemsTUERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> a (Yy <br /> a erator Name - ' Generating Location <br /> ' Address <br /> 1Tz--�ti� J <br />� ress <br /> _ <br /> r <br /> tea. +aw�v <br /> ne No Phone No Li <br /> r o Waste Code Containers Type <br /> R � � � - � � � 1 Type D - Drum of Waste Quantity Units No _ <br /> C - Carton <br /> ' 6 - Bag <br /> 1 L T -Truck <br /> ;❑ ❑ m ❑ P - Pounds <br /> Y -Yards <br /> ❑ � ❑ 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 condition for transportation according to applicable regulations <br /> m for Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> L/ 4 <br /> 1k No u Phone No <br /> Transporter Name Driver Name (Print) <br /> 4ess ~r Vehicle License No/State <br /> Vehicle Certification <br /> #eby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> it the generator site listed above out incident to the destination listed below <br /> T I <br />)n Signature' Sh+pment Date Dnver Signature Delivery Date <br /> DESTINATION <br /> Ate Name Phone No <br /> Jess <br /> eby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> I T_ 1 -1 <br /> d of Authorized Agent Signature Recei t Date <br /> PASS CODE <br /> sFizso 720 319, <br />