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ENEMA <br /> ISq 351•Dc)q <br /> Please pant or type.(Form designed for use on&%t12-pitch) tar. <br /> Farm Atrvad.OMB No.2050439 I <br /> UNIFORM HAZARDOUS 1.Gerwalor X)Number .2 Page 1 of 3.Ema,gen�y Rppf <br /> esponse Phone err ng Number <br /> WASTE MANIFEST CAD981571079 , 8QaT48-7449: C7 B F <br /> 5.Gen-raba tMrrm and Mating Addnye Generatoda Sfle Address(a ditkrara than maAhg address) <br /> 1N TATF TR=<,CENTM <br /> P:D ls{77[iS41E# S(7( 6 G4'9's200 <br /> sT0( +FpN"CA X380 ' <br /> raNtoe3 Piwwa00-3 N-.45 S <br /> pmhr 1 Compary Name <br /> U.S.EPAID Number <br /> �D�llTT1C31�IS;IN(;-�_.'� . . _CAA88i1d4&197° <br /> 7.T�poAer 2 Cor pang N�+. U. . i Nur* <br /> ml <br /> 16.DesipneW Fac7Mty Name and shAoam <br /> U.S.EPA ID wrbar <br /> 'RANO:Fi(?'OOR1�11lA;ACJ4�957�2a,�:. . <br /> FarilltyysPhone:`9!lf419BQ <br /> 9b.U.S.DOT OgnAptlorl ifnd i tg Roper r9 thma.Narard gores,ID Number 70.Carrteirera <br /> �' fl.Total 12 Urtk <br /> FNA and PION�(I am) No. Type � 4 tft 1S,woo com <br /> a 1 , U///���ly'F�1�rrr��� I Is 11arltrt1e61s; eec aoteee> ns1'lsaveallr� l�t <:,. f, . Dlip� 113�r: v D01bF1 <br /> z 12. <br /> 0 <br /> I <br /> 4. <br /> 1/,Spmal Nandlerg hnt uebon s and Addrlional kdar nWm <br /> ,f-.•'..PRQFIk�s+;�t7Q�1�M$CE{tl��rAH�48�L6��1:2!(�.- <br /> -AP.PROPMATE-PROTE-CT `CLOT"NG.:�- <br /> t 5- GCNERATWSI W"0fC3 CERTFlCATFDtt i hereby dedars Uret Iw coat'"of Ods consigrmsrd we*and aauM*dasrrted abowe by ria proper 3NMN marm.and am dao FOK tmgad. <br /> rrorked 84 IabeladfpiamMdl,ad we F al mop.*in pope=low far tr oVmt In9 b appi0tae tr"m Isl and r I-d gow-rre ntd mWalome If-spurt ahipnad ad tam!w ftwy <br /> Eaporhr,I cw*9wt ft cmft of Iris cnrwfgrmarA ctinlazn b the twnw of dw altb&ad ENAdamwisdgmant of Convent <br /> I prtly that Ira was"miymlmYM Otlsnrsrrt AMM in 40 CFR 26227(ori(If I an a I&W qu*Wwra x)or(b)(d I am a smap is" <br /> /Pl J j" <br /> 1 .h " <br /> ©Import b U.S. ❑EatparS from U.S. Por!of <br /> T-wortor signsk-(for sspab"# Dots bavkg U.S.: <br /> 17.TrrtiporlrAdumb#nsnt of Recapt of Materials <br /> m-porterkft tedRypsd Slgrekre Morih pR YUL <br /> ranspdhr 2 PMWyped Norms <br /> Moan Day Year <br /> ft.C[scegenty <br /> 18a Dapepencr Indication Space ❑ ouantf y ❑Typ ❑Residua ❑ParcW Rejedron ❑Fu1 Re(Sdo- <br /> Mardfest Ref wxe tiurnber <br /> 18b.Albrnah Fadlly{err Ganereax) U.S.EPA 1D Number <br /> lJ <br /> LIK Foo" <br /> W 1 gr Skrmtlo ANemah Fjocikty err Gomrotnr) Month DayYear <br /> �y 19.Fk-dotty wash sepal Management Medrod codas p.a.,coda for hward us wras>t Vaabrwrsk ftpoaaf,and mcfowg systems) <br /> O 1' H 12, 9. ]4. <br /> 20.DesigneW Fadlfy Owner or operaw c4dical m at mcefpl of harardma materiaM covered by Iw man hat ascepl ea nded In Ham 16a <br /> nahae <br /> L\Onr 0 �0 <br /> EPA Farm 87 (Rev. ) Previous editm are obsolete. <br /> O� DESIGNATED FACE iti"VTO DESTINAT[ON STATE([F REQU(R120) <br />