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47 Please Print or pe. (Form des[ d for use on ails (1 2 -pitch) !Vewdter.) UNIFOPAMAZARDOUS 1.Ganeratorl])Number 2. N WASTE MANIFEST 5. GenerabN Nome—a-WaTir ; Address LNWt" USA Lv ti�� %— ,% t Ck"Ar'M 'AwripsgA, "m ol , V� ME tc-ikxel Novam) D— Phone go 'a Ph no: go. '9b, U,S- DOT Description (including Pn)PefSh4#rg Name, Hazard CJass, 10 Number, W HM end Pecking Group (If any)) Mil j, ar 7M I c T o ti by dedere that "'s tents of P nsport according to -P aorrform to tlxr forme f Me -111a�ed 7�klun boo condition �and MM the v'3 S. MR' F 'SC Gus Ont are fully and awntBly described above by ft proper MVWQ name, and are dassiK .-d In Irs , pa(*". 'I at the contents of this t PIDICaM MWAabnal and nsfiorw govemniew *Lilabft. If export shipment and I am the Primary dwiedgment of Consent. to statement I In 282.27(s) (if I am a large quantity generator) or (b) (if I am a small quantIty, *oribr) I Coneratqrsiow-swt-lred/TypedNaigis I — Y 519nature Mon UF Day--VeO—r honalShipment3 16. Interne LJ import to U.S. ❑ Export from U.S. PortoltnWeAl: Transpodecairattmefor ax rts" only): g U.S.: 17. TronsportefAcicnowfedgmentol'Rec* ofMatarais Date leavin TRTPW-i �11 �Y* Name Signature Transporter 2 KMaffyped No.— AL Month --UF-7arr 18. Discrepancy 18a. Discrepancy Indloston Space -]Type El Quantity ❑Residue ❑Pas" Rejw'don Manifest 0 I Fi.RL. ef'odon 1Ob. Altenate Feality (or Generator) U.S. EP 10W�1 19. Hazardous Waste Report Management Method Codes 6-e., codes for hazardous waste treatment, disposal, and recycling systems) 3. 20. Designated ra66ty Owner orOperator. Certification of receipt of hazardous materials covered by the mardestexcept as noted In Item 18a Printeffyped Name Bfgnalure /* L EPA Form 8700-22 (Rev. 3-05) PjWous'edifions are obsolete' SEP 0 8 ?01� Month -E 7 Fn= Aproved, OMB No. 2050-0039 ency Response Phone1 fanifest Cking Number 4. h I 1006 FLE, a Sifte M*m (IT amonent an me ng addrm) U.S. EPA ID Number U.S. EPA ID Number U.S. in Number 10. containers 11. Total 12. Unit Type Quantity VWJVOL 13. Waste Codes ar 7M I c T o ti by dedere that "'s tents of P nsport according to -P aorrform to tlxr forme f Me -111a�ed 7�klun boo condition �and MM the v'3 S. MR' F 'SC Gus Ont are fully and awntBly described above by ft proper MVWQ name, and are dassiK .-d In Irs , pa(*". 'I at the contents of this t PIDICaM MWAabnal and nsfiorw govemniew *Lilabft. If export shipment and I am the Primary dwiedgment of Consent. to statement I In 282.27(s) (if I am a large quantity generator) or (b) (if I am a small quantIty, *oribr) I Coneratqrsiow-swt-lred/TypedNaigis I — Y 519nature Mon UF Day--VeO—r honalShipment3 16. Interne LJ import to U.S. ❑ Export from U.S. PortoltnWeAl: Transpodecairattmefor ax rts" only): g U.S.: 17. TronsportefAcicnowfedgmentol'Rec* ofMatarais Date leavin TRTPW-i �11 �Y* Name Signature Transporter 2 KMaffyped No.— AL Month --UF-7arr 18. Discrepancy 18a. Discrepancy Indloston Space -]Type El Quantity ❑Residue ❑Pas" Rejw'don Manifest 0 I Fi.RL. ef'odon 1Ob. Altenate Feality (or Generator) U.S. EP 10W�1 19. Hazardous Waste Report Management Method Codes 6-e., codes for hazardous waste treatment, disposal, and recycling systems) 3. 20. Designated ra66ty Owner orOperator. Certification of receipt of hazardous materials covered by the mardestexcept as noted In Item 18a Printeffyped Name Bfgnalure /* L EPA Form 8700-22 (Rev. 3-05) PjWous'edifions are obsolete' SEP 0 8 ?01� Month -E 7