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TO'EHD. Page 4,of 4 2014-11-14 00:52:43(GMT) 12097626954 From: RAVINDER SINGH <br /> ' f9TN'.b`u'"30Nro?dt81S,8WWO:f]TW?PD.Boo? , t$,$A*812-VWwW9n:' ad <br /> -Pleme printor 4pe. Form designediw vse on 6 -pitch)Wewletm), Form Approved,OMB No.2060-0039 <br /> .UNI170RMNAZAROOUS t. 'eiatdr lQ NmNter 2.Page t of 3.'Emergency Respuma Phone4.67Q�aynqifoet7taUrMo Numimr a <br /> WAM MANIFEST 107' 538 gAY(y(� <br /> 5,.GaneratmY Name and Mailing Adams OerzisSiteAC&sW(H'diFeWthan mailing address) <br /> H. <br /> 'y'YrBEro'fxRlvalTnU <br /> GenetalWs Phann:• -:A._ ' <br /> q. rterd any Nama "" ,S.EPAiO,Number' <br /> 7.Traisportar2Cnmpany NameLull� U.S.EPAID Nwnher <br /> aw. ' 8.Deb Pat fatal Nameagtl SdeAddress: U. .EPA@Nrintber . <br /> Fmm fjL wc." ENVIRONMENTAL HEALTH 7st� <br /> D SMITH AVE.14 DEI'ARTMENT <br /> FapliPJePhuro; 6Q'- 'y-'� <br /> in. 9b U.S.DOT Description(ind:Aig Pmper Shipppg Name,Hazard Ciesa,ID Number, 70.CONDOM 71.Toml t2 Una 13.Waste Codes <br /> Km mut Pahang Gmup(Nany)) No; Type Quantily W(Nol. <br /> K 1'h\t.Ndnh`;-put ei[?'a "C+itFF6YrARY]°9F,uQuiBST(k'S ume, <br /> 1i°P43PLTYr.�1R@(TfNt3k 1 exa. S",S` � <br /> Z IFk44-7s•",AA IiA 'f?Y„t"t.9Ctkd AMT,iS OM(E:4fat a,xT�c':'Tf'tl4rVu 223 <br /> f^fR'fi'7f#l�fi>'ii�fYS':r7Nt94 - _ _ <br /> 4 F7Ad k° <br /> t 3. <br /> pa <br /> S <br /> 6 4, <br /> f <br /> 1.4.$�eiral lq#u ,NaMNW imomlafnrr .... _. _ ...... <br /> t �a � �7$ %4__ <br /> { <br /> W 20M PAQ 17l-0" <br /> S <br /> 16.-GENERATOR'SIOPFEROR'SCERTIFICATION:.]hembydee fttthemnWnlsof BriecandgwnentamfulNanda retelydescdbedabovebyi*pMpershippingname,amtaredassiged,packaged, <br /> madretl and lalWad'phcardedr end min all fespecs in proper comABon for transpodaccadi g b auric"lntemall"iand national ti vernnuntal regulatom Itexpodenipment ardtam Ne Primary <br /> �. F�poMr,IcerUfytbatNe mntas afWs mns(gnmgntcmMmbdrelNms rdtire adadfai FPAAckrowledgmreMofCpaseN. <br /> 1 difylhatthoWMtadnhbi atl n stabment idenfed in 40 CFR262.27(9)(lI am alarge quantirygeneretor)ar(b)(if I me small que i tygenera"Is two. <br /> Ganaafot{J s PrinladlfypsQ tJama - 5gpa(um „ .. - .Nonan Day Yyear j <br /> 18:IntemelbnalSNpmeds . . <br /> ❑ . <br /> Impcdto U.s, ❑Fapart4am U.S. PoMofwfty(ed5. q <br /> Tmneporler Elgnature(for exports only): Date having U.S.: <br /> V.TrensPoderAdcrrgvledgmEn[PfPacea4ofNaledals <br /> Ira Wrter,1 ante dd^Name 51 Mundt. Dity Y,", <br /> F T2nsPonar 2PrlMed/,Tygod,Nmm Signature NonN any Year. <br /> 1B.D10mopency <br /> I 189.Dlxrepafq.indcalitn Space ❑ OuunBly ❑Type ❑Residue ❑p"Iflejeoaon ❑FWIRejndbn <br /> ManifeslRaferenca NwMar. <br /> j, Yeb.Attmmtafadfdy(.Genarabr) US.EPA ID Number <br /> 4 J <br /> I C7 <br /> FacWt(s Phone: <br /> ' you 18c,519nalum afANemale Facility(a Generator) Murdlr Day Year <br /> i r <br /> �y 19.Hazardous VWa Reppg"r'l Management Metlnd Codes(!.a,.cafes for <br /> hazardam mate treatment.dspasel,and recydlrg systems) <br /> 2 3. 4: <br /> F <br /> 20.DaslgnatedFa@GlyOmer or Operator:Cafkatlon of r Iptoflazardous materials wveved by Bre manifest except as now in Item 18a <br /> I PdmeWTypad Name +.f, cignaWre MpW Day Yaar <br /> 1/,Il <br /> ' <br /> 1/0 <br /> EPA Fovn S70o:22.lRev 3 Q5)P•ey oUs ed`.. a e odw ate:" DESIC+NAWD FACIVIN a 6ENEA,pMR... <br />