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?lease pont or type.(Form desi nsd for use on elite(12•pitch)typewriter-) Form Approved OFA8` - 9 <br /> UNIFORM HA7_ARf34U$ 1.Generator ID Number 2.Page,of 3.EmeWR Res,onse Proe 4-11an7@st Thx%ng Number <br /> YYA3T MANIFESTIC A L � 6 0 3 5 1 ; 8 3 � 4���� � �� J J� <br /> 5,Generator's Name and MaUi'ng Address Generator's Sim Address(if dHerent flan mailing add=). <br /> TRACY lW WRCVQY <br /> AUTO PUA W t <br /> MAGs95204 <br /> j C7atbn <br /> nersg sham: - �a <br /> ' l `r2R„porter 1 Company Name U.S.EPA ID Nu rater_ <br /> It- <br /> 1 7.T'armpceer 2 Ccrnpany Nam, ).&F?A 0 Number <br /> i <br /> &Designatad Fadhty Dame and Site Address U.S.EPA ID Numt-r <br /> DENF"r KSMOON <br /> ` N•ALAW-DA4TRWTCA 101=2 y <br /> Tadtl esPhone: <br /> 9a. 4d.U.S.DOT D"cription¢ndud:rg Proper$Nppatp Ha=d Clogs.ID Nlar09r, 10.Corrwrers 11:TOW 12-t1* 13.Wane Godes <br /> M and Padang Group(K any)) No. Type MMS <br /> NAM,aA US",M LI 4,W.3.,PESW.Pty Rt �1 . <br /> ry <br /> - 2. <br /> LU <br /> } <br /> 4. i <br /> i <br /> 1 <br /> 14.Spedal Handfing arae AdtliSonai Information <br /> EW4NWCY CMWyn�yy�y�q�'f:A� NIMM �t 1 : 7 PRORL9#984 ; M Ma POO <br /> At 10%4W"}�A'PF,�lr1!}ATE WW PRSTECIM EWPNENx <br /> 15. GE NEUMR%0FFS0R'S CE"FtCATION: t hereby declare that the carttertks of arms conslgnmerA are fully and amaratery desenWd above by Me proper r�dPPin9 name,and arg dassirred.Packaged <br /> mEXPO-ft, <br /> ,a�,r�,k� "�`•"r that <br /> ed and iabelod*cerded,and are in A respects in proper oondbon for tansport ac=ding to applicable krternatior�and raWnal govemmPrtt4 regulations.K expW shlPmrxmt and€an the Pnmaly <br /> EXPO-`�•�,I ±le mrlWO of t�s cort Oment dJn m to the team of the'a8ad>ed EPS AckroMedgment of Consent_ <br /> l attrat the rra a mvum�tion statC+rkM iderrded in 40 CFR 26227(a)(ffI am a large qusntity generator)or(b)(rtl am a w all q»rl7y generaior)is true, <br /> l eflerato slOfferor s Rnntedff 1dName Signature J hionth Day Year <br /> y <br /> -t 16,kttenatiooal Shipments <br /> ❑Import m U.S. ❑Expoft from U.S, of entrylew'C <br /> k Tramponer slrgrranrre(for export 0*): Date ieaving U.S.: <br /> L= 17.TranspoRer AMmjedgrt u t of Receipt of A4ater atg <br /> LL <br /> Tmr*pnrtsr 1 Prirtad�typed Name S gns ure Month Day Year <br /> a TranspGRsr 2 PrinfedTyped Name S gnatunS Mmth Day Year <br /> r-. <br /> 18.Discrepancy <br /> 18a.Disaeponcy Indteation Space Quantity ❑Type ❑Residue ❑Partial Rejection ❑RA Rejection <br /> Mantfc>h Rcfixr>s+ca Number. <br /> 18b.Atternate Fadiity(or Ganeramr) U.S.EPA ID Number <br /> Fad rrVs Phone, <br /> w 18c.Sgnah of Akernate Pacility(or Ger>eratcr) Month pay <br /> i <br /> tg.Flaaar rs Waste Report Management McMW Codes(i e„aides to ha2srdous waste treatment d6�osaI and rccycfu g sys4 res) <br /> C 1. 2- 3. 4. <br /> 20.D%gnated Facky Owner or Operator:Ce+Uecatiorl of receipt of hazardous matcnals covered by the manifest except as noted in Itram 18a <br /> P yped Name Signature Mont Day Year <br /> EPA Form 8700.22(Rev.3-05) Previous editions are obWote. GENERATOR'S INITIAL COPY <br /> bOc)i'7(.i0 d 9 v Q v 4 67 itl 7l OZ/Z7/80 <br />