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02/12/2010 10:42 FAX 17077471927 <br />I y`14TOPWt HAZARDOUS <br />ViASTE I1 AKiKS i <br />' I a. Cwtxntors Na, ane �wi <br />t� <br />k� <br />J <br />H <br />C <br />d 002 <br />rit1 <br />.•....�i.�Y, •_.. '.„'r.l l�l:�/s _. .'IFi ;, I.-�iJJ•ti J�: <br />? ^once PJrono-Y 4, 6lantfes t "r»G:ing Idurber <br />;a ; IFTOr e -m Vie, 7;Q r f <br />it � � • �' .. y. T ;; 1 <br />r �� J �_ ' '•�; tar::L,rr. t t = ACICIMs jr diMMI..IhDu nlaIrm a.'taresii <br />! <br />I ta. Soa.ial Handiina IitSUl:i'"J."i.n <br />/ i✓r �/. _ <br />15, GpWPATOR'SIOFFEROP,'S GWIFIG1ii0fd: I hereby dud= lhal the coments Ir this consignmcrrf Oro July and acauraraly dcscdbOd ObOve Dy me proper shipping nanx, find are classlfled, packaged, <br />for to applicable international an; na4onei governmental tegulations. !f cxpt+:l shipment and I am dts Frimar)' <br />martced and gtx"Vmrded, and are in all respects In proper condition transport :cxorda+e <br />k ExpOret, I O:* drat the coraents of this a,nsicpmwm conform sr Lis G:mG C pre attedred EFS, t damiedgmcnt of (:nrurnt. <br />idenfiifed in 4D Ct'P ?0"?.27(aj (r I am a large gtarrt4y' + j (h err a srtrrll n n , fj 15 CJs. <br />I certfly the: theSP77 wast& r ternikallon °nMl <br />1 7, <br />"Immu.latement <br />bltNltn %By Yea' <br />16. Inwnaliomtl ahlpmentsImpOR 10 U.S. Diixpon aom U.S.L•SPor I Os emrY/�xtr: __, ... ._ _ <br />.. ,.....•_ _..— <br />TratSOorCn amnuture'fta•• exn= OnIVI: Data Kwan U.S.: <br />Razaiptof Materials ^ f <br />17. TranspoTterAcknoa'bdlmenl Oi <br />IAontit ray e:r <br />lmnsptrtur l PI ntetll?yaer, IvamS <br />F'/��C 4C�jGF'�% I f•f' <br />F I <br />oZ I i r4.'p <br />j��(rZtr=• / <br />I Transpaw Z r'lintedriyW Flame $Iprra lire <br />To--- 33y rw; <br />16. Discrepancy <br />10u, Discreiww IndWilan Space © 4wnfi): Q Type ❑ Residua Pedal P.ejswion <br />��--II <br />I, .1 Full P.ajt.dion <br />W--nifes! Reference Number <br />I <br />lUb, rdler.+ete Facility (or Sanerator) U,S• EPA 1p Number <br />Facflllv's Phow I <br />Month Day Year <br />780. Signature of Nwn te=azliih, (or Cvene=r) <br />t <br />( <br />19. Ha:ardaus Wasls Repe, Munugnrent Method Codes fix-, cadt:m for ha'erdous waste aaatmenl, drup.W, nnC rear JIng symerlsj <br />1 <br />I ?.0. Designated Fadity Orme; or Dpoloor Oentfteation of receipt of Irazxdous mamneir, mvizd by the 111140! except as noted in I10n:1 F*. <br />rYionth Day Y&+ <br />Frin!ed?ypadklmB SignaiLtrc <br />&r@ obq* — <br />•—:.IG iF REC- i!F . <br />