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Please pdMo (Formrdesignedtoruseone" (1 i wri .) Form Approved 0MBNo:205b-00 <br /> UNIFORM HAZARDOUS 1.GonVator IQ Number 2.Pagel of 3.Emergency Response PMna Tracking Numher y <br /> WASTE MANIFEST C a L O o 0 28!4 7 8 8_ 1 6oa4a�s3oo JJ <br /> S.Generators Name and Melling Address Generator's Site Address(if dgwrent men malting address) <br /> SwAwwy Inc. Sakwwy FWW 92707 <br /> 8818 SbFnpMpw Will Road 6426 N Pal Avw. <br /> PleaserAm CA 94888 SbelAon CA 96207 <br /> Grm4: ,a'Fhane: 9 2 6 4 6 7 - 3' 0 0 0 ` <br /> 6. renepoMr 1 Company Name U.S.EPA ID Number y' y` <br /> �►0n �:6aQr.lnc. CA R 0 0 0 2 1 7 5 1 3 <br /> 7.Transporter 2 Company Name .S.EPA Ntrtmer r' <br /> 8.ttw=Illwt Dedgrated Fadlity Name and Site Address U.S.EPA ID Number <br /> NX. <br /> 6380 91d xn Of <br /> I(wnws CNy MO 64128 <br /> Fedgys Phone: 618 924.6884 IMOD 9 8 1 1 2 3 3 9 4 <br /> 9a. 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers 11.Talar 12,UCH 13.Waste Codes <br /> HM and Pad"Group(If any)) No. Type Ouantily WL/Vol. <br /> x IoN1983.Vil Hong- Nrpldt,mos.AgnoW w).3.P08 boot DOt B 343 <br /> w <br /> - a <br /> 14 <br /> E!� <br /> .specs s - 18L,I,E AbsolbwM,GwsoNn< `*dwF- a.. u2 42 ERCW 8'.- -. •"°`". <br /> N+we,ee,tpr+ /XSs��, o)- <br /> 15. GENERATOR'SrOFFEROR'SCERnF]CATION:I hereby derdws that the contents ofmis consignment are fully and accurately described above by the pincer shipping name,and are classified,packaged. <br /> marked and labeled!placarded,and are in all respects in proper condition for transport according to applicable intenaboral and national governmental regulations.tlexport sNpment and l am the Primary <br /> Exporter,I tarty,mat the contents of oris consignment conform to the temns of the attached EPA Admowedgmebof Consent. <br /> I mriy that me waste mini mutation statement identrfad in 40 CFR=27(a)(8I sm a large quansy generator)or(b)(til am a small quantity generator)is We. <br /> rafDlfemrs PdntetlRy Nemo sign / Day .. <br /> lad <br /> 16.Iq tlone p - <br /> F ❑import to U.S. ❑EtPod from U.S. Pat ofedryleadt <br /> = Transporter signature(for exports only): - Data waving U.S.: <br /> 17.TrensporterAdmonledgmen of Receipt of Mal <br /> Tr r t Pdnledllyped come ey V;- <br /> mnsporW nl yp come Signature nm Day Year <br /> 18 Discrepancy <br /> 18a.Discrepancy Indication Space ❑ OuarNty ❑Type El Residue El Partial Rejedan LI WII Reject�c <br /> Manifest Reverence Number. <br /> 186.Allemate Farildy,(a Genarear) U.S.EPA ID Number <br /> J <br /> V <br /> LL Fadlitt's Phone: <br /> Q ignalum of mate Facility or mar ay Year <br /> 2 <br /> vt1y 19.Hazardous <br /> jj Waste Report Maragemend Method Codes(i.e..codes for hazardous waste treatment,disposal,and recycling systems) <br /> f <br /> 2D:Designated Fadllty,Owner or.Operetor.Codification of receipt of hazardous materials covered by the manifest a of in Item <br /> bminseure Month.4Ph <br /> year <br /> YPed Name ` ) - -, /�- <br /> 112 <br /> EPA Forth 8700.22(Rev.3.05) Previous whitens are obsolete. ( ' DESIGNATED FACILITY TO GENERA OR <br />