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St d C�IMornia--FSsatth and We0we Agency DepWrneni a ieclrn Sera <br /> r,„nk-MAcprvvd Oros Na 2=-0039(EOm 9-�01) See Inwftcilons on be Id page 6. Talc Subelorm Contra Ptoa <br /> Pteay print or type. Fam dsr✓gnad lar use on erffe(U cw, wwrfa1 Soaatwtru.Gw+ta <br /> UNIFORM HAZARDOUS I Gerwrotorr LA EPA Ie No MlarWeu o=Wmrr M. 2-Pepe 1 Inform olonin me rhaded oma■ <br /> WASTE MANTFESTI� 1of .; r not req.""by Federd lour. <br /> i I I (: l• Ir Ir.. <br /> 1 Gerrerat0/1 Norse and MlcAng Addreu r Ag31 <br /> i':'✓�C':'.r...4. <br /> �"#' ;u <br /> f \flxl/ T,r r7 :l1�+� t `rr`I '1 ' <br /> 6.� Offs{ <br /> nwalr't s '' ; '•r" f �.. ..:3s :. ,aor�'J-{,`r `f '"" <br /> Pr'ror+s( ) .r.,. .r. <,�' ,r.-�ati-k' '.{a''/Y"�:1:�..� ,.�.r�=.•r�ik:.til.. .a.. i- .1...:... <br /> frcrepoAer i Compery Norm e�lS EPA 10 Number -- <br /> ! t <br /> 2,7ronponer 2 ComocrW Nome 0 US EPA r0 Nymher <br /> C. ml_od Fac Norr+ nd Silo Address 10 LIS EPA ID Number ''G:,4Fgfit- ;tom c%^ 'X <br /> Mr4 thy_ Q h: a <br /> L rr "' i.il fr "-r :>hs• ';1 �sf -fix Er � 1y#f i� ci l <br /> 1-1771 '1 <br /> .f. .- . . �nf �, .. -• _ •- I 1 I r 1=:1 , t' I I- �'s `�::>�� l �1��� '�`_ <br /> 12.Cordolners IS Tota[ Id.Urvt <br /> 333 11.l8 COT Gneription[incsu "Roper!,h0Q:rq Name.tiC2arc Can wc,:U Numaa,•) Na. T puant' WfNa -=I.+Hodv Number <br /> CL <br />�7 v G <br /> Tj <br /> r;• a -77 <br /> b E UJ�}STE -Q4zo SoZ ,s t _ .J..: <br /> .a ` <br /> T C. ?yx } <br /> :F O x 6K > <br /> r„E <br /> swc)ntq t..-`�t �[ <br /> G}`:`•�{{ti 2jj.`,:} �vX:2� y� <br /> I'-'r .vi>%':':'�:•: k.'n:-: ;{:. : - �3C' s :h! ,+xti <br /> w k a <br /> 'JV, ¢ i Fvrri L ! --•• '�"�r4� dL� <br /> LLPJ- <br /> 16.Speclol Mona"li snucibn and Addnlonol iroorrroron <br /> is L`. I NI.R ti',GRVGNCY \[.�..../ r, a �}' ',L'.`'.! ..1��[�r 1 <br /> , <br /> Lu <br /> 16. CENEI ATOR7 CER1FFICATION: I hereby dociors trot the contenh of this coreigrvneru are furry and occurate?r described obove by proper shipping narw and ore ckmfmd. <br /> :O pocked.mocked,and iobsle'd.and ore in d rerpects In prober condition for fronsport by r,lghway occofdinQ to app✓Coble Womalbod ord rkotb d gowrrminl reg,.iwcna <br /> Qrf I om a large ouanlny gerwfalof.i cony stat r have a p+agram In prose 10 reduce the vokme and laxIeity of whsle genererted to the degree I have detartuwd to be <br /> r-- searorneaYy pfaellCdble Ond Rapt I hays 161WC't*0 mo pfvct,caow method of trerrim*nt,rtompe,or dhposal currently CV040ble to me whsch mhlrnkes nus pmwni aid fVt" <br /> thenal to hurrrn hsahh and the en+Norrrwnt;Onf I om O vnar avdnrrry generator.I tray*made a good folfh effort to rt+Wrntre rrry waste generation onrd M4cf the best wane <br /> management method thot ls ovollable to me and Inar f ed+atord <br /> PrkwolffyPod Nome Sgnarwe ATorlrh pay `yea <br /> f 1 <br /> C T 17.Transporref I Aelrnowb dgemsnt of Pvc@01 of Mgtellos <br /> 0 R Pnnfed/Typed Name sgnaruro Mann coy rev <br /> r .1 A <br /> d S <br /> 0 18,Transporter 2 Ackrowie enwnl of Pecelpr of rtr7'Drnrs <br /> R Prinfed/Typed Fkzne r sgnafuro MonthLby yea <br /> T <br /> E <br /> Q F IG.Docrepancy indication Spore <br /> �.- A <br /> 1 ,I C <br /> t.- t <br /> L <br /> 20.Fo:llfry Own*r or Operator Cenllcotion of mceip,of rcuoroosa mclenou cov*rsd by the monAeit exce pl a noW in+I am 14. <br /> i T Pnnrrdylyped Ncwr,e Sgnature Month COY f0a <br /> Y <br /> (Zia I lkic f <br /> DO NOT WRITE BELOW THIS LINE. <br /> -_J <br /> DrtSaaZ2A(12/o0) Green: HAULVF RETAM <br /> � A <br /> 97a°-22 1 <br /> 'I r <br />