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Sane Form deW^ed of Catibrtwo-EnNra+w+d Prowction AgWCY . <br /> $ S <br /> JI A oMa No 2050-00391��91a! Instructions on back ej a 6. Deponmenr of to=r sabnwKe.eamrol <br /> oV�f' M w an e6fe(129frc - 5«rom.r.ra.Co41err:e <br /> fTeae piM or type. <br /> 1. Cwrrrafo/s US EPA ID No. Manilest Document N�' I 2. Page 7 I :nformorian in d+e rhodad areas <br /> UNIFORM HAZARDOUS f 1 I,rof required by Federol cw. <br /> WASTE MANIFEST h ✓rlW c ul " YI ' G i i I I r .r of ; <br /> Ted. WaA1a.'tw+'DecayaE rrudi:r -=ti- <br /> 1. Grrralo/s Name and A1a1n0 Addres+ <br /> C <br /> n <br /> vA. G ..,ier4 Phone <br /> m 6. Us EPA ID Nwnber <br /> h Canpsarry Nana - <br /> a S. Trorr�orar 1 <br /> C? 7 t C r� w r': A 4 `� `' 1A <br /> 7. Traupader 2 Corrgony Name 8. US EPA ID Number ,�.... , '_ "F�'G•h. <br /> U <br /> 'Q Name arI Sift Address 10. US EPA ID Nwnber <br /> Z I 9. Dttipnos`d FodMt'.i. 1 f i r. - .`•i 3r. E'� <br /> �� <br /> Ylr <br /> )a r-.; w1 LC3.•-�. �-�_•�� -j '} '� -� ''I `I I r � r r �k3� <br /> U 12. C. i.. 13. Taal 74. Unna._^ <br /> Z 11. US DOT Daeeripfcn(nduding Proper Shipping NoI Hazard Class,and ID Number) No, j T Civantl�• WrJVoI I=Wer. :� 1 <br /> ��., o. rr 7:_i:r, ___. ff__�s.-�. _ ?.. r.a ___ -•_] I �gysTe%y _ <br /> 3 G <br /> m H b. <br /> m <br /> R I ! .,i <br /> ail �SmA <br /> T j <br /> O <br /> d. <br /> W <br /> U <br /> O <br /> Q 15. Spedd 1 k..A g Ytlrudons and Addlfenal bff ..016- <br /> 77r7 <br /> 1 err-=- <br /> W <br /> 2 <br /> proper shi 'n wme and are classified. <br /> 16. G7316UTOR'S ®1T89CA710N: I hereby declare that the comenfs of this coaignmenf ore fully od eccurofM d plic b le above byePP` l <br /> Q pocked,maned,and cbeld,and.in all re+pecn c proper cardifian f-VamPort by highway xmrd'ang ro applkabfa unlevrnafionol ad notional gowmmeM tequbtians. <br /> Ube <br /> If I am a large praefly,}araror, I<erlify oral I haw a program c place b radon 16a wknne ad fo=idy of wersfe 9enerored ro the degree hhe deter Ond to m <br /> aceromkdly praaicoble od fhn I haw selected the procticable method of eremmma,ftmge,or dbPewl mm'" y available ro me"nidi minimizes the and <br /> II and a be. <br /> a I haw made a good faith effoA ro mcimbe my waste gmeralion and select the bas! <br /> rn Ilsrear ro letrm hedlh and Yfe erniareaenf;OR,'d I am a anall gnwrafy gmeralw• _ . <br /> CLlermta melsod III 6 rsak 66 ro ma and thof I can Hod. _ Month Day Year <br /> OPrkaed Narr i• ,^ e <br /> Z T 17. T 1 A rei of Reof Maferch Moritls pay �JYear <br /> Ur Primed Karat v <br /> 0c s i <br /> If 78. T 2 A eF of Alafedok Mosyh Day Year <br /> W i Prkdd/Typd Nana ro <br /> O i _ <br /> yWj 19. 1)...Pacy krdkalion spare <br /> VF <br /> A <br /> Z C <br /> - 1 <br /> l 20. Foaft 0.of OeIIfe0o,s;erfiFaotian of of hazardws maMia6 ea.ered Mb nnsmifsa eznof as rofed in Mem 19. <br /> f4:dad/Typd No Noah Day Yea <br /> sipnofare <br /> Y I I ( I ( I <br /> DO NOT WRITE BELOW THIS UNE. <br /> Yeliow: GENERATOR RETAINS <br /> rDTSC 11=A (1/95) <br />