Document 7RZ8YM1K64qj4GekGGjJ2jOqe

DE 000058 D E 000059 -77 o f A w th e iliw ) A |* n i ' 15 Texas Department of Water Resources P.0. Box 13087. Capitol Sution ^ Austin, Texas 78711 i TEXAS WASTE SHIPPING--CONTROL TICKET (Please Type or Print Clearly) QM1Q934 Ticket No. (Satisfies TDyR, TDH and U.S. EPA requirements for hazardous or class I waste manifest) PCAoRmTpIa:nyTNo abme c. ompUleNteIdObNy GCeAnRerBatIoDr E(seeCreOveRrsFe..sideCfOoAr TinIsNtrGucStionMsA) TERIALS DI V 7rm"uo"/TMrnu Rea.stratson xu, No. K|3|[ lHll1l1o0l1.f9li Business Address P.O. BOX 3370, BROWNSVILLE, IX Address Prom Which Shipment Originates: STATE HWY. 48, PORT OF BROWNSVILLE 78520 ePA Gen. # G3caii[jiJUL:ata Emergency Phone A/C 512-831-4501 DESTINATION: CITY OF BROWNSVILLE. SANITARY LANDFILLTDWR/TPH P*rmit No Primary TSD Facility Name IOTT31 Business Address ___________ MARKET SQUARE Dest,natron (Site) Address PORT OF BROWNSVILLE. BROWNSVILLE. EPATSDFac.# II 1 1 1 II PhnneA/C 512-83)[-3641 1 NAVIGATION DISTRICT Alternate TSD Facility Name ___________________________________________-- Business Address ----------------------------------------------------------------------------------------- -- TDWR/TDH Permit No. Destination (Site) Address EPATSDFac.# Phone A/C_____ 1. TEXAS WASTE CODE 179390 Circle one: 2-quantity UNITS* a.6 1 2^)4 12 3 4 12 3 4 12 3 4 12 3 4 12 3 4 1 2 34 12 3 4 (1) tons (2) gallons 3' DOT WASTE NO. 1 IN/A 11 11 11 11 11 11 11 11 i1 1 1 1 1 1 1 1 I 1 ) 1 1 i1 1 1 1 (3) cubic yards Special Instructions: HANDLE SO AS NOT TO MAKE DOST 4- DOT 5. HA2 CLASS (a) DOT DESCRIPTION: (b) TYPE AND NUMBER OF CONTAINERS N/A 1 1 1 1 1 r 1 l 1 (a) ASBESTOS-CONTAINING INSULATI01 (b) OUE DEMPSTER DUMPSTER 1. 1 (4) drums (55 gal.) 6-0 -32. Data of Shipment This is to certify that the above named materials are properly classified, described, packaged, marked, and labeled and.ere in proper condition for transportation according to the applicable regulations of the DOT, TDWR, and TDH. /h/i Signature of Authorized Agant PART II: To be completed by the Transporter/Driver (see reverse side for instructions) TDWR/TDH Trans. No. Carrier Name BROWNSVILLE NAVIGATION DISTRICT Business Address P.O. BOX 3070. BROWNSVILLE. TK 78520 Phone Number A/C 512--831--4592______________________ .. % rESEL^ EPA^rans.NoJ I certify (or declare) that the materials in the quantities described above are received by me for shipment to the above named destination. Signature of Authorized Agent ~ PART III: To be completed by Treatment, Storage and Disposal (TSD) Facility Owner/Operator (see. reverse side for instructions) - TSD Facility _____CITY OF BROWNSVILLE. SANITARY LANDFILL Phone Number ____ 512-831-3641 Site Address PORT.-OF BROWNSVILLE, BROWNSVILLE WAV. DIST. TSD Facility Owner/Operator Comments:______________________________ ______________ I certify (or declare) that the material in the quantities described in Part I are received by me. _< TDWR/TDH Permit No. EPATSDFac.# llll 101 1121 71 3 -/7 - ^ Oata ftaeatvad______ ok Signature of Authorized A#*nt PE 000064 *,mm*r+d a * ' ' ( /UT^5 ** * *! A o ^ H . MJfc*?' DE 000068 D E 000076