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Please py or type.(Form designed for use on elite(12-pitch).typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFO AZARDOUS 1. namtor ID Nu r r 2.page I I if 3.E r ne 4.Manifest Tracking Numb" �� <br /> WASTE MANIFEST q 002583936 <br /> K . <br /> 5.Generators Name and Mailing AddGenerators Site Address d different than me <br /> 6:Trensporier 1 EverCompany Name U. <br /> gkxien Environmental Seivio<es bwwm <br /> 7.Transporter 2 Company Name - U.S.EPA ID Number <br /> 8.Designated Facility Name and Site Address .Eililga eii Olt.Inc. U.S.EPA ID Number <br /> 518-M4400 SM Smith Ave. <br /> Nwark.Ca.U" CAD 7418 <br /> Fadllys Phone: , <br /> ga 9b.U.S.DOT Description(Including Proper Shipping Name,Hazard Class,ID Number, 10.Containers it.Total 12.Unit 13 Waste Codes <br /> HM and Parking Group(if any)) No. Type Quantity W Wol. <br /> Q/Cy ,s <br /> Z 2. <br /> w <br /> 3. <br /> 4. j-,. j� <br /> 14,Spocial Handling lnstiu s and Adddtonal Inform@,__.__ ._ _.. _.._ _.. . ..:.€:.• <br /> Wear I ve rJuipm ° EAW 1 <br /> Inwiice#y� ' S OrdtiMf i <br /> 15. GENERATOR'S/OFFEROR'S CERTIFICATION: I hereby dedere that he conterde of tkls consignment are fuky and accurately described above by the proper shipping name,and are classified,packaged, <br /> marked and labeled/placarded,and are in all mapecla In proper condition for transport according to applicable International and national governmental regulations.If export shlpmant std I em the Primary <br /> Exporter,I party that the contents of this consignment conform m the terms of the attached EPAAcknwwdedgment of Consent / <br /> I party that the waste minimization statement Identified In 40 CFR 262.27(a)if I am a large quantity generator)or(b)(if I am a small quantitygenerator)Is two <br /> GeneretotslOAerors Printedrryped Name Signe ra/, Month Day rYear <br /> 7 , <br /> J 16.International Shipments ❑Impod m U.S. ❑Fxport .S r^ '.P o}antry/exit <br /> Transporter signature(for exports only): , D leaving U.S.: <br /> W 17;TmnspoderActnowled entofReosptof Material9 -� <br /> OTransporter 1 Print /Na Signature Month Day r_ <br /> Z Transposer Printedayped Name Suture Vonth Day Year <br /> rY <br /> I <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Space El ❑Type ❑Residue ElPartialRejection ❑Full Rejection <br /> Manifest Reference Number. <br /> 18b,Alternate Facility(or Generator) U.S.EPA ID Number <br /> J <br /> U <br /> LL Facility's Phone: <br /> w 18c.Signature of Allemate Facility(or Generator) Monro Day Year <br /> a <br /> z <br /> H19.Ha mrdorrs te Report Management Method Codes O.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> a 1. 2. <br /> �Iv t <br /> 20.D%*g iW FadityOamer ter Operator.Certification of receipt of hazardous materlalsc wed by the manffest except as noted in Item lea <br /> PrintedrTyped Name / Signature 1 Month Day Year <br /> EPA Form 8F&-2 (Rev.3-05) Previous editions am obsolete. DESIGNATED FACILITY TO GENERATOR <br />