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Please print or type.(Form designed for use on elfte(12•pdch)typewriter.) Form Approved.OMB No.2050-0039 <br /> UNIFORM WAROOUS 1.Generator lD Number 2.Pagetof 3.Emegency Reepanw Phone 4.ManNest TmckIng Number <br /> WASTE MANIFEST ._ !. 6 0 0 : ' 1 z: 000931673 VES <br /> 6.Generators Name and M&g Address PACTIV PACKAGING LL,,' Genwithor's Set Address INddMmnt than meierrg address) <br /> 4545 QANTAS LhNE SAME <br /> Generamrs Phone: . <br /> f­4 Pike <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> , <br /> 7.TmnsWW 2CaapeMName U.S.EPA ID Number <br /> AN 07 2Q5 <br /> S.DesNr*W Fad9y,Name and ShAdd n!jhvV r.F,;;7SCH)11CAL.SGLUT1�.-W. U.S.EPA ID Number <br /> ;n4 i," FIRST STaU,a ENVIRONMENTAL. <br /> FadN s Pham: <br /> :1 SY i`7 IVIV.,1_. '�.`. 911,02 14FA!TW nFD6Dl7UCAIT t err <br /> 9a. ge.U.S.DDT Desolp6on(hkdv Proper Snipping NwA Hamtdgem,D Mm6e4 10.Containers 11.Total 12.Unit 13.Wada Cadet <br /> HM and Padang Group ldaM)) No. Type Ouantiy WWd. <br /> Oc <br /> z 2. ::-'S4-11s. 9L VIJ:•LMRJI p YJLI :[J GGI. r 4 <br /> w <br /> r, <br /> AL"11:. i� 6wL 1 S <br /> + n <br /> 4. <br /> 14.SPKW Handling lrmbtctlona walAddreoW lnbotatrol 'SfMCe SmTtra7t.d 1.:'. :-'t:' -i 7t71J.i'.4 F4':-''`S I KF a-1 1)MAI, <br /> 6'-'.i;i)rao •. m ),dl 11:.:-..-;i C?BE/FUnL(NS _ - <br /> 15. GENERATOR'S'OFFEROR'S CERTIFICATION:I hereby dedam that the contents ofthboorapmmm am"and acoa telydmm'bed above by the proper engpkg name,and m classified.PwMged, <br /> marked and labebNyaeardnd,and"In all respects N proper condition for aensW amordkrg to sppaceble intem5orelend national govemmental mgulab=.1 eepom sNpment and I am the Primary <br /> Esyrtr,I covey dot the oontentsof trds mnsi wend confrm to trn team of da atradbd EPAAtlopMsdgment of Conant <br /> I om*trust the waste mk*nkaWn stemmmt Identl6ed N 40 CFR 262.27(x)('d Iran a large quamery generator)or(b)Qfi arra smell quantygenmtoO 4 tete. <br /> G mwaueaOlfermes PrNbedlTyped Name SgmaturB_ ; Mwd Day Year <br /> 16.IntematiorW Shpnems <br /> ❑Impart to U.S. ❑Eryon from U.S. Pod olenmy/ado <br /> Transprtr agnabrm(For exports onh'): Dare leaving U.S.: <br /> K 17.TmnspoWAdmowledgrnemt of Receipt of Materials <br /> Tmrevoder l PMMdVrYped Name <br /> Signature l,�i �:7 MorAI DaY year <br /> ji <br /> uo TmnspwWr 2 Rind Typed Name 5 mhae Month Day Year <br /> 1 18.Dbsry <br /> eban <br /> I 1az.Ofsaepary Indicatton Space ❑ Ou maty ❑Type ❑Residue El Pemel Relate, ElFull Relsebon <br /> Manifest Reference Number. <br /> 186 Aft mals FaoTM(rGenemlor) U.S.EPA ID Number <br /> J <br /> U <br /> W Facifdys Phone: <br /> a 18a Spasmus ofAhemate FacMy(r Generaeat Mo M Day Yew <br /> 2 <br /> N19.HeraNars Wade Repel Merusgemant MetlwO Codes(I.e.,mdmiorhazardous waste beahnenl disposal.and regdkg eyeWro) <br /> wQ 1 2. 3. 4. <br /> 20.Desgnated FeaTM Owner or Opembr..CMificaeon of recelpt of hazardous materials covered by the teen"attept es Med in Item 18a <br /> ♦III PrinleoRyped Name roue Month Day Year <br /> EPA Form 8700-22(Rev.3-05) Prevlous editions are obsolete. GENERATOR'S INITIAL COPY <br />