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PrNo 1067842 <br /> Systems <br /> FWaste ERRIS INDUSTRIES NON-HAZARDOUS SPECIAL WASTE MANIFEST <br /> lerator Name - - Generating Location <br /> ress Address <br /> ` <br /> a t Jam. t i <br /> line No -I -1 1 Phone No <br /> Type <br /> BFI Waste Code m - - - Containers D - Drum <br /> Description of Waste Quandt U C -Carton I I I I El Ili- <br /> B - Bag <br /> - T -Truck <br /> ❑ ❑ P - Pounds <br />' 1 Y -Yards <br /> ❑ �r`� � O-Other <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260W10 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 /> G or Authorized Agent Name Signature Shipment Date <br /> TRANSPORTER <br /> - <br />�k No t '. � -' Phone No J` <br /> Transporter Name Driver Name (Print)( � <br /> 4ress Vehicle License No/State <br /> Vehicle Certification <br /> I�reby 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 /> D r Signature Shipment Date Driver Signature Delivery Date <br /> DESTINATION <br /> Site Name Phone No <br /> J- <br /> ress <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 /> N e of Authorized A ent S1 nature Receipt Date <br /> PASS CODE <br /> ' 9F1260 720 3193 <br />