Laserfiche WebLink
1. <br /> ' S <br /> N <br /> IP <br /> UNIFORM.�y g"-..0,MW--� <br /> L 9stnrYdh US EPA D Nag. <br /> .iAs $iAll 114 lY Asd"MMaYaMM�W,�t,L .i <br /> late.sou--f 41l�kssww' <br /> + ` <br /> L-rl,ltrYatol't Ihiii,lwW'iY�i�.AtNn,a _ <br /> 4. elenwarfolsPhone ) Ji.4 7 _ <br /> S. Tnnr ortr 1 Compo y 8. US EPA D NAanber� -G<8t.W I _ 1 <br /> 11,1 I D:T s <br /> 7. Transporter 2 Company Name e. US EPA t0 Number "Fs;+34fe SMM(Wbat'��' <br /> F. Traeaporbfa Phoa, _ <br /> B. o )gnted Facility Name and Stt AAdress lo. US EPA ID Number G. State Fatlitya to <br /> SNIP �f.rzvr {j <br /> it <br /> I 24104, IC A CnUV 1717 11 A" <br /> 12, Contanrs 13. Total 14. <br /> 11. US DOT Description(Including Proper Shipping Nam .Hazartl Claes,and ID Number) Quantity Unit dYasta No. <br /> No. Type VIA/Vol <br /> a.NG <br /> ` `l y./ �(y� �{ / j - `� � eves <br /> E WII D F `,D 1t 1,- L4 19 IVo& Qcd I Iwo <br /> d101par <br /> E b. <br /> R <br /> T r <br /> O .: <br /> R <br /> C. <br /> e. <br /> J. Additional Description br MNMdala LWadJlbove <br /> p( <br /> L <br /> 16. Special Handling In,truction,arts AddMolut Ydorrnst)on <br /> I <br /> 1e. <br /> GENERATOR'S CERTIRCATIOW. I hereby dedwe'tlrtthe consent.of this eoneigmment are fully and accurately dascribed above by proper wuppng nam <br /> and we ela"i ied,packed,n artiod,tandJseeMd.and we in all respects in proper condition for transport by highway according to app4wble intereathmi and <br /> national oovemmetlt rayulshons. <br /> If I am a large quantity garrerator,1 orthy err thevo a program in piece to reduce the volume and toxicity of waste generated to the degree I have determined <br /> to be ecorwmiuy practicable and that I have selected the practicable method of treatment,storage.r disposM currrdty available to me which mmunc es the <br /> present tiedhoursthrew to hvtian health and the'arwaraesnt:OR.If I am a small quantity generator.I have made a good f dth effort to minimize my waste <br /> generation and select Me beat were masigassma- itod that Is avallable to m•and that I an Afford. -- <br /> Prmt Typetl Neme / Sane _ Mono+ Dey—, Year <br /> �i75 lLAGI:'eF loll I Ii <br /> T 17. ransportr 1 AcknowledpaalrM 01FAsceipt of Material. <br /> R <br /> A Primed/Typed Nema - Sierra Monts Day Year <br /> S ?'E l C M <br /> 0 18. Transporlr 2 Acknowledoeme d o1 Receipt of Material _ <br /> Ft Month Name Slpeature Monts Day Year <br /> T <br /> E <br /> 10. Diacxpancy Indication Space <br /> F <br /> A <br /> C <br /> I <br /> L <br /> 120. Feell' r or r CartNeatbn of receipt axardcoa metenale coveretl by Mie mils espapt ss ed in ee to- <br /> y P ed/Type ems Signature J Math Day year <br /> +S$022 A(1/ee) Do Not Write Below This Line Yellow: TSDF SENDS THIS COPY TO GEE TOR 4TFIRN 3b DAYS <br /> A 8700-22 <br /> �v.&88)Previous edition.are obsolete. <br />