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PWNINC-F <br /> Waste No 1067855 <br /> Systems TMERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> • s - <br /> Ilerator Name F- Generating Location <br /> cess € ��- Address <br /> ne No Phone No <br /> BFI Waste Code m - j - - - Containers TYPE <br /> Description of Waste Quanlit Units No T pe D - Drum <br /> ❑ - Cantors <br /> B - Bag <br /> T -Truck <br /> ❑ m ❑ P - Pounds <br />' Y -Yards <br /> F-1 I I ❑ m El -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 /> 3epokrator Authonzed Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> TF k No Phone No J Jy J <br /> Transporter Name Driver Name (Print) <br /> tress Vehicle License No/State <br /> Vehicle Certification <br /> Ireby certify that the above named material was picked up I hereby certify that the above named material was delivered with- <br /> a <br /> ae generator site listed above out incident to the destination listed below <br />] r Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> _ r <br /> E 1- <br /> Site Name Phone No - <br /> Iress <br /> re buthorizey certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and accurate <br /> 1 of Ad Agent Signature Receipt Date <br /> PASS CODE <br /> 8FI260 720 3193 <br />