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_ 1831556. <br /> or type.(Form des fined for use on ehtet(12 pdch)typewriter.) ^a _ *. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator D Number , .,;( 2 fie l of 3.Emergency Response Phone 4.Manifest Tracking Number D/"�I <br /> WASTE MANIFEST C f g — 00 <br /> 5.Generators Name and Mailing Address r Generator's Site Address(if different than mailing address) <br /> Applied Aerospace StrilCill Applied Aerospace Structvre <br /> P.O, !ai 6195 343J SO, AIRPIIRT VAT <br /> Generators Phone: t 7 t7 8'- iJr 1 7 , - <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> 7 (-? t. P P P + n <br /> 7.Transpormi Company Name - U.S.EPA IO Number <br /> 8.Designated Facility Name and Site Address - U.S.EPA ID Number <br /> 2.tsi Century Eorirom i l %tialireot of NevaAa, LLC <br /> 2195 Nevlands Jr. East <br /> Facility's Phone: , 6' i7S - V G=U013. <br /> ga 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Total Codes <br /> HM and Packing Group(if any)) No. Type Quantity <br /> 0 tlON-RCRR iiRZARBOVS VAST£ SOLD (6%WTE PRE-PRE£) 331 <br /> w z. VN3992 ERVIR%M.GALLT IAiZAMS .Si1BSTINCES, LIQUI), N.O.S. 343 <br /> Y (1-PROPAl POTASSIN DILNUE) 9 PSIII 01 nE 7 F <br /> 3' UNi711 ILII COI£ rk LIr34iIB5, U.S. ISI LRNIC AM, ACETM) 1 1912 €1113 751 <br /> X PSII 801112=1901) 09 CJI .ZS� P <br /> 4' WIN NUEFiI111iU WlM,.TOXIC, ORWIC, N.O.S. (BEBRIS C BB9i 1117 B135 <br /> X ACE'fOilE, CMVfOIIIUN) 4.1 13.1) PS1I loiN112111LIS) U� Di" �3z�s £ <br /> F <br /> 14.Special Handliog gsWctions and Additional Information <br /> I1) fin 13-13 - SUMTE PRE-FRES (1) 532261-11 - ERSi111) 1-PROP)iMOI/POTASSIUN (3) SR5115 93 En 13-13 AC1)S Y/ <br /> ACETOW (TI !4) SRIIII-14 - ERS(131) SG VB7 VIDES l X 5'/At- (3) 2x/SGkc._- <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION: I here by dedare that the contenis.ofthis consignment arefully ago accurately described above by Me.propershipping name,and are classified,_packaged,_ <br /> . _. . __ - <br /> marked and IabeledlplacaNed,and are in all respects In proper condi8on for transport according to applicable international and national governmental regulations.If export shipment and I am the Primary <br /> Exporter,I certify that the contents of this consignment contain to the tens of the attached EPAAcknowledgment of Consent. <br /> I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(dl am a small quantity generator)is true. <br /> GenemmeslOBerors PdntedlTyped Name Signature Month Day Year <br /> 0 <br /> J 16. Memalional3hipmen ❑Expod fro Port of t d: <br /> 1- '.d,. ❑Import to U.S. Date leaving U.S.: <br /> F= Transporter signature(for exports only): <br /> W <br /> 17.Transporter Acknowledgmentof Receipt of Materials <br /> K Transported PnntedlTyped Name Signature Month Day Year <br /> O ��.E'..fw l 4 <br /> C <br /> 4 Transporter2PrinedlTyped Name - Signature Mon Day Year <br /> 18.Discrepancy <br /> crepancy Indication Space ❑ Quantity ❑Type ❑Residue ❑Partial Rejection ❑Full Relechon <br /> Ma <br /> 18b.Alternate Facility(or Generator) U. . IO Number .a <br /> r0(NIOGB fe'7n)9(5)zi <br /> . <br /> 0 for, and Will occept tfm Was <br /> te <br /> I Facility's Phone: <br /> W i80.Signalure ofAtemate Facility(or Generator) IS generot0r isS)11pp1(a9. Month Day Year <br /> 4 <br /> = der 19:Hazardous Waste Report M`anagementMethod-Codes f.e,codes for hazardous waste real disposal,and recycling systems) <br /> 2. 3. <br /> 4. <br /> H 1`f I I H 1 C4 it (-f 1 L/ <br /> 20.Designated Facility Owner or Operator:Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a - <br /> PrintedRyped Name S,2 04T .Signature & <br /> ' Month Day Year <br /> EPA Form 8700-22( ev.3-05) re s editions are o solete. DESI TED FACILITY TO Gffftl <br /> 06-10-14P01 : 27 RCVD <br />