|
_ _ fSrolR.Pf Cgr12(orma Em ironinentel Pratechon'Agpncy � lw* '� ECEwED
<br /> P&an/iPYaovdr161M8 Na;=20�9jE. rose 9.3D.yq) J88 1nxiruchons on IT of page b. YYY
<br /> Please print qE ygp vFo 1Tr'desig fw use ort
<br /> a, f12 jl2-pitds)ypenrihr i ,QH]y(ime tat iaxw 5u6sancov(onb<
<br /> /iU(y CI Ot 1 P
<br /> UNIFORM HAZARDOUS T' Cieneroior s US EPA Ib No, �14
<br /> �*� �11 �IFF
<br /> In rma the s PWASTE MANIFESTA81
<br /> IC F EMERG ENC ^
<br /> 8. Ceeama)arsNawe otd Moiling Addnsf A bemoM ablest Docemeni Number
<br /> t '!t yiLY�7}13Rf � gvR}IT+(�ryt'Ey'F G .3 0456
<br /> contort PlwrASEWOM
<br /> ro(T'°7 � +� g 3tPM(L,VQ tanwmrs In 33,�. I II,�
<br /> n 5. Tranepo mer 1 company Nam. a. U$EVA ID.Number RB_ . I* 13 k°s M"kJ IP+ 1 I
<br /> C $hmaTranspesser'sID1 an ,j
<br /> c I FL,T ft ftEF3 f FtL3 SVS TAY'._]yp { f D Tran.parc«.Ph.,
<br /> 7, Tromosome r 2 Cowpony Nome - s +° __C r 1^ ._.C:_
<br /> � B }US EPA 10 Nimebts_r�yg,„.�¢ �g :E, $roto Trenspan."l IOj&u- ve,md,I '---
<br /> W✓� i°"F'C3{+5$' "j'�y.x".. _ S""^�"ygiw,.".•c•P` f` Y' P i'�I` E, T,mupotm 's phone __
<br /> noted pociU ----- fi4CW4
<br /> pp 8 T mod Sae Addrgss 70. US EPA ID'Numbm G, 5tnee Foc 3 yz tD
<br /> Fl3f�t R@ C�1TW, ServTCes, SSC.W<
<br /> Ldf�
<br /> i;3 .}YSE ,$ly6TTl7
<br /> _J:r..R�.l�
<br /> 0 ff i&J t!n, (`A 92416 L q =t�
<br /> t tfilt3t2i ?C11�
<br /> ZI 11, US DOT basdripllon(9ncfadog Prop.Shipping Name,Hchold Chiles,end ID Number) 72. Con,Oimes 13. Tnto1 ;A_ Umt
<br /> Z j" _.._ No: T Conant Wt/Vof i WaxfoNmmber
<br /> t?2I RCCA I' i? iT£1d}41'' Wr'USIT `sol T1.,_
<br /> i
<br /> $ Ca
<br /> E N
<br /> ry,. : f'
<br /> o N ... .b..
<br /> E FILTER RECYCLING SERVICES' RIAL 6 �
<br /> 4 R �2A444&T HAS THE APPROPRIATEnPERIM (S) F Re _
<br /> �v A : ._...... -AAei-tise{:'liG EPA/+Other
<br /> g o AND WILL ACCEPT iitS WAbT[ $
<br /> R
<br /> d. Sroyo:.
<br /> W
<br /> tri j I
<br /> W EPA/Cillo,i
<br /> I AA
<br /> ZR6ryg1 RosvipiiSnblbrMaario`jr•L Yed Above K. HPrdling Codes fix Wuahic tj ed
<br /> Alone
<br /> W a
<br /> t$, Spacial Hondlirg Instrutlmm and Add Hanel in{omolion -----_-- �`-"-^^--------------
<br /> ------
<br /> K
<br /> a'.
<br /> zieAape clothing tC.JCATTCN: �??{544?"mea$ency ResTx)nse 4 (}0 ) 21- 203 1469 f,.ffAPNTt
<br /> 1 @
<br /> 5`TYkI cA gs2C➢9
<br /> dib. GENERATOR'S CERTIFICATION: iirmoby de<(aro rhoethe conbnh of this wnuggmnerlforefallyamil.,ururoiyy dauobad olsmo by proper shiQprng name and aro dosslf ad,px4ad,
<br /> U marked,and labeled;and are in all—whim proper condition Car irnnspert
<br /> Irk" according b oPptwoblm irvoma,iorval and naliwsal gmsvnment ragPloripns
<br /> J
<br /> o. R I omen large quoiniry gonorctor,I carefy thin I hove o ram in place b no6co rhe of..and wxiciy of waste ganmotud to the&0'..1 have determined to I+o nennan,icoliy
<br /> H pragli Wil and that 1 have eelecied 1M'M"cobla meihodo treom,ent,storage ser dnpewl currently available a me which minimizes the prca.nt and farure throe,to human hoeith
<br /> awl Ih 1onvironmenk OR,if;qm a smn I gaaniUy gemardror,I hay.mod.o geed faith effort to minimize my waste gonnrabon and soled the best wo le onmeam,wnl morhaT'fh.f is
<br /> nroilpbla to ma and.that I con offord.
<br /> > Prinbd/Typod Name -_____ __ _
<br /> $iRmomm.
<br /> Z Tm i a�1�tt`.1 G .. �` l._£Jr` fl'h-L.i '14��.: C .,✓ �LfxPi .�.. �n I A l i
<br /> N57, Trons r 1 Acknow! rel Rew .nF McMriola
<br /> — _
<br /> yaj At Promed/Typed Name Si nota --------
<br /> If
<br /> _____....—,_ Month Doy Year
<br /> G If 8
<br /> OM T8, Ttans rNr2Apknaw—Imdeoment of Remi oTMesedab--- _
<br /> w PiihNAlTypod Name ___ StgrwNre Mnnth Doy Year
<br /> d R
<br /> I V f 19. Diurepartcy GdieaBon$pace
<br /> z A
<br /> C
<br /> I
<br /> t
<br /> 1 20. Foc@ CM ra4 wbrC 'f' omen 'scat i of hoemdous maMrials covm d Ihis wonik.l exce;lo "�d ��om-�ff
<br /> YPrinrod/ Signasure Yaa.
<br /> DO NOT WRITE BELOW THIS LINE.
<br /> y6ko',' iSDF $ENDS THRi COPY TO GENERATOR WITHIN 30 DAYS.
<br /> DTSC:8022A 11/99) fC''onorafors who sabmit hu.'Joar wnslo for 1"nsporl aat-nkloie_
<br /> EPA 8700-•22 prbdvice co-Peed;apq offhts copy and ser-: ro DTSC w`thm ;III seep}
<br />
|