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Pleas4'print or type.(Form designed fbF use on elite 024pi sif)typd"ber.) Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS 1.Generator ID Number2.Paget of 3.Emergency Response Phone 4.Manifest Tracking Number <br /> WASTE MANIFEST C A L o 0 0 2 8 0 7 s s 1 W0,04MOD, 1 015492923.- JJK <br /> 5.Generators Nemo and Melling Address Generator's$its Address(Ifdigerent than malting address) ., <br /> Snkvmy Inc. StAnway Full 82707 <br /> !SERE SWarkip MIN Road 6425 N PMCM C Aela- <br /> tolrasgMets 4`A tgIBK CbclAoss CA 68207 <br /> Generators Phone: 9 2 6 4 6 7 • 3 0 0 0 <br /> 6.Transporter 1 Company Name U.S.EPA ID Number <br /> ErNWOrWalfti Logi9lk 6„ C A R 0 0 0 2 1 7 6 1 3 <br /> T T2 2 Company NameI �! U.S.EPA IO Number <br /> 9 L*C09cN TraNs of �a�yvn .0 c , QK Iq 0090 7 y 6( <br /> S.Designated Face Name arty Site Address U.S.EPA Itl Number <br /> li�srrral Mc. , <br /> 6300 Sbdun Dr <br /> Kani anClly MO 64129 <br /> Fecilitys Phone: BIB gr?4.58UMOD 9 8 1 1 % 3 3 9 1 <br /> ge, 9b.U.S.DOT Description(inducing Proper Shipping Name,Hazard Class,ID Number, 10.Caneirwre11.Total 12.Unit 13.Waste Codes <br /> HM end Paddng Group(ifany)) N0. Type Quentry WUN01. <br /> X 1U141993,WASTE Flartanab%kgtdds.n.os,4gawW*),3,PGII '! Pbn Sy >' /� Doot_1Q018' 343 <br /> kZsa 2 <br /> 3. <br /> 4. <br /> 14 Spedai n ling Insbacb.om,end conal In1pb metlan . 1 NL,1.El ADa6fbald fl1a�/IM Q(6' or-AESE?7 ERG/�2E;IMM17 7 ' <br /> �_ ...n ( IFS <br /> 15. GENERATOR'SIOFFEROWS CERTIFICATION: I hereby declare that Ne contents of this consignment are fully and accurately descrbed above by the proper shipptg name,and aretlassified,packaged, <br /> marked and Iabeledtplaarded,and are N all respects in proper condition for transport according W applicable international and national governmental regulations,Ifexport shipment and I am Ne Prhnary <br /> Exporter,I certify first the con ants of this consignment conform to the Mums of the attached EPAAcknoMedgmem of Consent. <br /> I certify Net the waste minimization statement identified in 40 CFR 21(t I am a large quantity generator)or(b)(if I em a small qupntry generator)is We. <br /> GenemloY Tor PnntadRyppd Name SignaNre /x' !' /// Month ay ear <br /> Xj 16.Inmr-wenal ShIpments Ll import to U.S. ❑Export from U.V Pod ofentrylelah <br /> r <br /> = Transporter signature(for exports ony): Date leaving U.S.: <br /> 17.Transporter Acknowledgment of Receipt of Materials <br /> Hy, ranspo, I PdnWffyped SigneILI Month Day Year <br /> 10. <br /> � b <br /> r <br /> L V D OG'�'! i t^/ /� Monty Day Year <br /> Name <br /> .4 1e.Decrepanq , x• ' <br /> Ise,Discrepancy indication Span �1 � <br /> ❑ Quaytly <br /> rr��-T�1 , ugype I LJ Residue' Partial Rejection ❑Full Rejection <br /> , <br /> Manifest Reference Number. <br /> 18b.Altemate Facility(or Generator) U.S.EPAID Number <br /> v <br /> LL Facilitys Phone: <br /> 18c.Signature of Aternale Fealty or Generator Month Day Year <br /> 4 <br /> N <br /> 19.Hazardous Wesfe.Repon Management Method Codes(i.e.,cedes for hammous waste treatment,disposal,and recycling systems). <br /> wo 1. i •,, ` 2. <br /> ,I- 1 <br /> r 20.Designated Fadity0wner or Op"p;Cellficatidn of receptor hazardous mateials covered by he manliest gxcalil ash 1"16z <br /> r' nn ante •� gnaWre r fa�;1um ay Yew <br /> EPA Form 8700-22(Reva3-O ),Previo4 etigons'am obsolete. DESIGNAIIED FACILITY TO GENERATOR <br /> ®ale. : tn41. , 4. <br />