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moT.ry ±•�yr,7s <br /> tae dr tot "ty <br /> [ um mai9ned lar ueeoa ebu 112bifinl typmwibr f s •••� ^s.l:lu s?;/+ � �y �N C;T�"v;. .'y`b'!s!' <br /> NON-HAZARDOUS 1. Generators US EPA ID No. Manifest 2. Page I M <br /> WASTE MANIFEST CAT. 0.0• 4. ocument No. of <br /> 3. Generator's Name and Mmling Address <br /> �4tS �6L rbbn S1�ccf STac�kfah Ch `1 <br /> A. Generator's Phone( 1 Z(�g 004 .1 <br /> 5. Transporter 1 Company Name 6. US EPA ID Number <br /> PM1aralc _.k.l Son T�� l�.n nc GA •L • 0.0.0.0.Z.7.7 .4. <br /> 7. Transporter 2 Company Name 8. US EPA ID Number - <br /> 9: Designated Facility Name and Site Address 10. US EPA 10 Number A. Tranaponer's Phone <br /> C. Fa<ili8. poner't Phone <br /> Jill ja"tk ANi�t^ Xsi4a� oPliry''s Phone <br /> M^^14-cti GA 1+ S336C A.1110. •'i•4• 3 .3 2-4Z,;st$ <br /> 11. Waste Shipping Name and Description 12. Container, 13. 1A. <br /> Total Unit <br /> NC. Type Quantity Wt/Vol <br /> a. Non - Nc�tCkardGt..s l./astL/ SoV;d <br /> o•( aoo• a Y <br /> 3 Is. <br /> N <br /> E <br /> R <br /> A c. <br /> T <br /> R <br /> R <br /> d <br /> 0. Additional Descriptions for Materials Listed Above E. Handling Codes lot Wastes Listed Above <br /> jnS ii 13 5 @ 3 <br /> 15. Special Handling Instructions and Additional Information <br /> 16.GENERATOR'S CERTIFICATION: I ovet, the nummak desaibed abetir w mix ..Iw an rot subject its federal re9uktiena for reporting proper disposal al Haaardaus wane, <br /> Printed/Typed Name Signature /JMamd Day root <br /> � S <br /> T 17.Transporter I Acknaw edgement of Receipt of Materials <br /> R <br /> N Printed/Typed Name Signature ._ "u", Doy Your <br /> S '•fir' / :'r/: r r `. V /",-, _ / �/ � / • , ;.i <br /> P <br /> 0 18.Transporter 2 Acknowledgement a4 Receipt of Materials <br /> EPrinted/Typed Name Signature Mento Day Yeo, <br /> R <br /> 19.Discrepancy Indication Space <br /> F <br /> A <br /> C <br /> a <br /> L 20.facility Owner at Operator:Cenification of receipt of waste materials covered by this manifest except as noted in Item 19. <br /> Print /Taped Name / an rh Si at ure / (/ Oar y is, <br /> � <br /> TRANSPORTER #2 <br />