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FROM VILLAGE WEST ARCO FAX NO. : 2094782013 Nov. 05 2002 10:47AM P1
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<br /> u,rty Ifxplrci 7•JO.941 See Instructions on ba
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<br /> ' UNIFORM HAZARDOUS I h)+�+�+I^si Dycymcnt NuInfnn+,.,be+n+n the sh�d,:.I u•
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<br /> WASTE MANIFEST 'lel,equired by rccl.,td low.
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<br /> H. Focili,y'6 Phone�.Ib� LIF'1
<br /> 11. U5 DOT Do6criplion(including Proper ShippingNgme,Hazard 12. COnlUinels
<br /> Class,and ID Number) 13. Tok+l A. Uaif
<br /> z U. 6-Rt, lk ry -•.,h �,� L i �� No. Type ovonlily Wt/Vol I. Waste Number
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<br /> J. Additional Descriptions for Materials Listed Above
<br /> K. Handling Codes for Wastes Listed Above
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<br /> QF �rl4prsl-gdling Instructions and Additional Information
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<br /> 16. GENERATOR'S CERTIFICATION: ,hereby declare that the contents of this consignment oro fully and aceurolely described above by propership Ing name and are classi
<br /> U marked,and labeled,and are in all re:paet6 in proper condi,icni for transport by highway according to opplicoble internationo)Ond national government regulotions.Fiod,pocked,
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<br /> dIF I am O IOrge qrhouantiy getwolor,f certify that I have a proggrorn in plata to reduce the volume and toxicity of wall&generarnd to the degree I hove determined to be economicollrr
<br /> N and the cin�anmenrnd t!ORYef i lcctcd oaf a the rauont ble method of treatment,,forage,or disposal currently ovoiloble to me which minimizes rhe present and Future threat to human Mfrh
<br /> K ovai1n61a to me and chat I ry.+afford. q �'generator,I have made a good faith&{torr to mlr+imine my wasto generation and select the best vroele management method that ie
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<br /> y Printed/Typed Nnmo r S;ghaturc >
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<br /> /,Trona orfer 1 AcknowledgementI Z'�+ �j .:r•�•,.
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<br /> I .l of Raroiol of Materials —•
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<br /> sa ran& orter 2 Acnowled ament
<br /> O A 4 oTReccipt of Mathrials
<br /> W T Printrd/Typed Name Signature
<br /> QA Month Day Yeor
<br /> U 19. Discrepancy Indication$pose
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<br /> 20. Fociliry Owner of Oocrator CerliFicalion of receiot of hazardoub mokriol:
<br /> covered by this monifesl exec 106 noted in Item 19.
<br /> T Printed/Typed Namc Signature
<br /> Y Me„rh Day Ycor
<br /> DO NOT WRITE BELOW THIS LINE.
<br /> DTSC 8022A(1/99)
<br /> EPA 8700-22
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