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Oct 29 04 10: 15a <br /> zn 'ZZ! <br /> (E=ras 9-30-99i <br /> -Qr--_'ror use on 3hie(72-piO'ita, to.. 17.1c <br /> 1. Gener4,for's Us EPA ID No. S- <br /> 1 L 1 7 LI <br /> A. <br /> crid mail ing Address <br /> L4L <br /> "'c"er <br /> r'- Phone <br /> ,1 4. Generator's Phone(.1 L4 <br /> C. 5twe Trarzperter's I'D��­O,`IGC i <br /> o US EPA 11)NLM.60i; <br /> Trnsporlef I Company hlo;�e ortk-�Phone <br /> D Tran!;) <br /> 7 E Stale TranspoOer's ID <br /> o. US EPA IL)Number <br /> 7, Transporter 2 Company Name <br /> F I an'por nr's lhcne <br /> Stale Focili-'s ID <br /> 9, Oasipwad Facility Name and Site Address I C. US EPA ID Number <br /> H. Facility's Phare <br /> 2. Toia 1. Wave Number <br /> _oqto'nel' <br /> I US MT r svioti., �W-r ki�ppi.,)Nlw-ne,�H..ard Class,and ID Num6erl Ty <br /> :ate <br /> cc <br /> 0 <br /> cc <br /> Stale <br /> LU 1 <br /> F <br /> zil'in5C­!;nr :.ird Ao­ <br /> tiopol Descriiations jar Materials LisleA,60v%-+r­= <br /> -7 <br /> z— <br /> S. Special Handling Instructions and Additional Iniormation <br /> C)3 <br /> 7 i% <br /> �'Optir:1, <br /> tell <br /> .,qcontentja�this cons nmentarehs5yondotcurat Ini,cliongi c-d jo_.,o.jcj cz,,�rimarl raG_tor:o­ <br /> r,ElIE,%AT,CiA'S C'_:'jTlFlCATlON. hereby declare that- <br /> -ION <br /> 16=A--- n for iransPot y high-ay oc�ccrd'nc to a LCO <br /> mo'Ked,and lo!3eted,and are in ail respects in proper condNc <br /> +e'.9'_ 'c-del.,,ed to 6t ecaoomwolly <br /> If I I ge,tor, 4enify lh*l I ha,,,e a program in place to reduce+e miume and toxk�ty a[wc:;te uor.droiei, �il ari�fut,-4 rhraUT IC ItUMOC h0o" <br /> If I am G large O'Coil d disposal cu <br /> avo;�06e a nre.lhi�h ni�n:imli�z:f"r M.1"d tool is <br /> ,.C, qS' a 7c�or treatment,31orio-� 1.06,23.ment <br /> L_ *r=CI;ccIaIe and that I aye selected the practicable men, ioitq effort to miAmnnize my-%l'jz­'oi'On..,A"ai2ct:he r�" <br /> d �riii''anme Cr <br /> i�I am a sma�j quantity men,tat.i Inoeie c Rgod <br /> t;Id the envIrOnme'V:CR <br /> available to and kol I can 09-6. -Day Year <br /> ...... ...... <br /> Signature <br /> 1,6. <br /> Prinied/Tywed Nome <br /> 7Tran --------------- <br /> nc�,Ied amen,.1 Receipt 0;V.cw�ok 'fear <br /> . <br /> ed/Typed TACrot <br /> 8. Trars-_cnor 2 ReceP-1 or More"O's ,.nen th UOY Year <br /> signov'r, <br /> �rnte&-yped Nome <br /> Discreoath;;:7�­iiccfion Space <br /> b !lhij manifest ax�aol-n octet:n <br /> F-61;t- or zTceccior':&7i-icationI cf;o,of ication at r azjorcaos mo;eriaj:cove, <br /> N.asc <br /> ------------- <br /> '991 <br />