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a No �_ <br /> Waste <br />• Systems TM NON-HAZARDOUS SPECIAL WASTE MANIFE <br /> BROWNING FERRIS INDUSTRIES <br /> GENERATOR <br /> Generator Name " ' " `-1 Generating Location <br /> Address Address <br /> ❑❑�— _ - <br /> Phone No Phone No L�—J <br /> L_L�iJ <br /> Cantatner?; T' <br /> BFI Waste Code [:L]::= 0 <br /> [:I:]= <br /> Description of Waste Ouanttt Units � �P? D � <br /> ❑ I �u; B B <br /> T - T <br /> E1= Y - Y <br /> EI= ❑ r � ] El -:=:� <br /> O C <br /> I hereby certify that the above named material does not contain free liquid as defined by 40 CFR Part 260 10 or any applica <br /> state law, is not a hazardous waste as defined by 40 CFR Part 261 or any applicable state law has been properly describ <br /> classified and packaged, and is in proper condition for transportation according to applicable regulations <br /> Signature Shipment Date <br /> aGenerator Authorized Agent Name g <br /> TRANSPORTER <br /> Truck No -� Phone No J <br /> a -u• _ - Driver Name (Print) <br /> Transporter Name <br /> - - Vehicle License No/State <br /> Address <br /> r- - Vehicle Certification <br /> V hereby pertify that th@ above named material was picked up I hereby certtfy that the above named material was deliverer <br /> at the generator site listed above oft incident to the destination listed below <br /> J <br /> 1 <br /> Delivery Datc <br /> ' <br /> Shipment Date brivef Sighature <br /> Driver Si natu e <br /> DESTINATION <br /> r <br /> Phone No <br /> Site Name <br /> Address <br /> I hereby certify that the above named material has been accepted and to the best of my knowledge the foregoing is true and acc <br /> ReceE l Dat <br /> Name of Authorized Agent si nature <br /> PASS CODE <br /> gr <br />