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Waste <br /> FERRINDUSTRfES No 1067853 <br /> S <br /> ystems TM NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> 3 1NG- <br /> lerator Name Generating Location <br /> n ; -A - <br /> I• �. Sul �4i i Address `_"�ress u` - <br /> v <br /> Pine No - Phone No <br /> Containers <br /> BFI Waste Code L 3�! - - - D Type u <br /> Description of Waste Ouantity Units No Tyype <br /> ❑ I�`� C- Carton <br /> 8 - Bag <br /> T - Truck <br /> ❑ W ❑ P - Pounds <br /> Y - Yards <br /> FT <br /> [:1m F] O- Other I I 1 -1 <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 /> 1 <br /> Ge for Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> Tjk No u - -= Phone No y <br /> Transporter Name 1 t Driver Name (Print) <br /> Alress Vehicle License No/State <br /> V T Vehicle Certification <br /> I Ireby 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 /> ' <br /> Driver Signature Shipment Date Dnver Signature Delivery Date <br /> DESTINATION <br /> Site Name Phone No <br /> Alress <br /> I reby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> V of Authorized Agent Signature Receipt Date <br /> PASS CODE <br /> 6F1260 720 W93 <br />