HomeMy WebLinkAbout2023-12-18 Liquid Environmental Solutions - Non-Hazardous Waste Manifest (Grease Interceptor) Manifest#23121005851
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SOLUTIONS - LIQUID ENVIRONMENTAL SOLUTIONS
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NON-HAZARDOUS WASTE MANIFEST
Name Contact Tune
SUPERCENTER#1861
Address Phone
5815 NORELL AVE 6514397476
City,State Zip County
STII LWATER,MN 55082
Customer# Profile#
42415900062 #N/A
Tank#1(gallons) Tank#2(gallons) Service Frequency
2000 1000 12
Tank#3(gallons) Tank#4(gallons)
0 0
Generator C 1lfladon:I artily the waste material removed fom the above premiss does not contain any radioative,laminable,explosive,toxic or hazadous material("Excluded Waste").The
tem"hazadous","mataials"is defined as any one or more pollutant,toxic substance,hazardous substance,solvent or oil as defined in or pursuant to the Resource Consavation and Recovay Ad,
the Co prdtasive Environment Response Compensation and Liability Ad,the Fetal Clean Water Ad,or any other fdual state or local arvimmental law,regulation,ordinance,or rule,whether
existing as ofthe date of this agreement or subsequently enacted.I also admowlege that the Generator shall be responsible fir any costs incurred by the Ttasporter or Disposal Facility in handling or
proper disposal of any hazardous waste aid that the Generator expressly agrees to defend,indemnify and hold harmless the Transporter fon and against any and all damages,costs,fns and liabilities
resulting tom wising out of any suds hazardous waste.
Originator Signature Date Time
SUPERCEN I ER#1861 12/18/2023 02:50:19 PM
TRANSPORTER INFORMATION
Company Drives Name
Liquid Envi ofifef1al Solutions KASEY HARRELL
Address Phone
9199 DAVENPORT ST
City,State Zip State Registration#
BLAINE,MN 55449
DEPOT
Transporter Certification:I sadly that the information above is accurate,and that only the waste cabled for removal by the generator is contained in the servicing vehicle.Ian aware that
falsifation of this manifest may result in proc suction.
Driver Name Signature Date Time
KASEY HARRELL 12/18/2023 02:50:16 PM
RECEIVER/DISPOSAL INFORMATION
Disposal Name Contact Name
METROPOLITAN SEWER-MN
Address Phone
2400 CHILDS RD
City,State Zip County
SAINT PAUL,MN 55106
Route#/CDFA Manifst# Total Quantity Recieved Gallons
01KH 3000
ACTIVE
Certiflation of Receipt:The dove waste wen revved by the facility within the property bowuheits aid will be pnxmaal,disposal oS or mcydal in annular=with all applicable laws.
Facility Representative Signature Date Time
METROPOLITAN SEWER-/v 12/18/2023 02:50:12 PM