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„ R I CLEPN FAC I L Fr'r PHONE, N0. : 775 577 9199 Jun. 135 '2000 10:49AM P2
<br /> '.b,r,;�En.ironmanrol ProMCr�on Agency .
<br /> JPO' omb No.2050-M39IExpira:,9.30.9911 See Instructions on back of page 6. Geo* ,�� ,,i Toxic Su6ne„r.,Cu,.r
<br /> � aM pe. Fenn des,' ned For V1e an ofix I la-Pilch 'l
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<br /> UNIFORM HAZARDOUS 1• Gcne.aror;JS EFA FD Ne. main esl Document NO. 2. FaOe i nFerrw en in tke shaded«.e,
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<br /> WASTE MANIFEST C:A' Dr Q. 4' Z! 1 5., a $ 2. ; 0.. 7_... eFZ
<br /> .J._GeneraroCif.Y�lrq.and�vloilinEl Address - _ ”' - A. Slate Mande:!DOWMcfft NOmUrer ,
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<br /> lV 3. Transparrer I Campany Name - 6.-'v5'ea4'ID r.[e,nber G. Slag P.'i IQ'Aesarred,]
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<br /> 4, natal !'ea+eR and Srle Addrrns 16. u5 EPA ID Number
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<br /> Addffow.(0'criptions For N Wiols listed A,60" K•ad
<br /> Mand:ine Coda far Wafres Used Abe+.- t:_
<br /> Z 15. Spedoi Handling inanver:ons and Addil;0401 miarmoGon
<br /> a— APPROPR16%TEPRQTEC VE Gt@THM .F I
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<br /> 16. GWEAATDR'S COMFICATION: I hereby declare thel the conlrnts e*]h&can;: nnenl are luny end aecuraieiiyy aescribed a6a.•c 6y proper shipping aarna end are cfass;r".packed, A
<br /> V I marked,and labeled,and oro in"Fl recpe04 in proper:ondi6on For lronspart by highway cKwding ro cp0ioWdo inmrnpt orrol and national 90"mment reguiatiorL,. u
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<br /> J IF l am a lotsm quant;ry generelar,I candy mar 1 hove a pro rim in place to.cd,rce the-olume end l=. y of.ante!rfirated to the degree I ha-e dmenn;ned to 1>r erico[
<br /> y proclieabl,and that 1 ka".wlecled r:'ta proCr:pabie molhod of rrsa mgnt,Maros.,or d4pewf 0rrren01 a.cifabie lo me which minimi�ea she.�resenr and Future lhrcat ro hu=hwlth
<br /> and the 6n.fonmenl:OR.iF f am a::roll gwrMy generator,1 have mode a good Faith m' mite ac gcncralioa and-71
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<br /> _ y I I P.inted/Typed • � � J V/ Sign � Menfk �ay year ,
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<br /> u.l T 17. Trcn 1 Ask led .meat of Receial of Mareriols
<br /> R ►Aen 11, Day Year �i
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<br /> Printedryped ame ,gn re Month racy Year
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<br /> {aj I 19. Discre [r 4ndicvtion Space
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<br /> � ?0. Fac;lire Cf-mer er Oura,er 4an�fitei:an of taco; :of harordoa:mora.�oi:cer.ered b +bis manifarr etcx res.,er 'n item'.4 -
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<br /> DO NOT R]TE $ELOLN THIS LINE. U
<br /> ,SDF SENDS THIS COPY 70 D7SC W171-.:u 30.JA-S.
<br /> DTSC e022A 11/991 To. F-9. qox 3G00, $ocrornenro, CA ?W.2
<br /> IPA 0700-22
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