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t <br /> ltl' p,y 7'�t5.' !�15 C04. k x00, <br /> r <br /> Pisses print of type. Fofttt Ow1011ed for us9 on t#Nta 12 pHclt t dwrlter•) ForMAp nVed.OiIVIB W.7.066-M39 <br /> UN)FORM NAZARDOUs i.Ganoakr ID Number . . Ro6ponne4.MwdfostTraaka:q NNbar <br /> WASTE MANIFEST 0 0 ;7,;Z f•'+aOv xzr—tob 010828262 J <br /> K 11 <br /> &Geivaata's Nam a fd*tg Addresa Goremloea Silo Address{if dlgetant q sn ma*g admesa) 1 <br /> OAlz (a S <br /> c cs!'�7J d;-1- a <br /> GoneratoN Phonal Z09-> <br /> 6.Tronsporier i Com Name U.S.EPA ID Natnbnr l <br /> 7.Trumportor 2 Cattpa ry Nona WA.EPA b Number <br /> 0.thedtpca f a Rity Name and SAa/address U.S.EPA ID Marbar <br /> ga„ 9b.U.S.DOT Oowipaon OmLiAV Proper Shpphg Noma,hazard Class,ID Number, to,Contakuus 19.Totat 12.UNt 13,;Nash Codes <br /> yu av d Paddrg Grcx!c(If arry)} No, tyge Quark MJdot <br /> 1-1 A44.1� <br /> 003 <br /> 2. i.AM1�;;D7t� G�s�r ✓f'lf'Yr�F ,��S'�z4&V�,, <br /> i. U•V Z8110 o,�'r'e �+�o's '! �v� , ail• s <br /> f?j 003 � <br /> i SLi-I <br /> -arrd',ing tns;n4ka endAd Worrtvtlon „r�'6 rb i 9�5,r�irt r alp+ , �x is bJy <br /> tfi. 6EN RATGR S/tSPFEROR ti CIERt1FICATiON:I hereby dacigm that the coclwks of Ods consigmaar k are fully and a«.r dey daon9yod apses by the proper'shipong nares and errs d"lled,pariwged, <br /> market!atul tabatt dfpkarded,and aa•s h all respects In props oard iloo kr Yansport accor iry to applCgbla InleffOanel and mrgoaal pmmmmtol reg:datlona.If oxport shipment and I am tho P&WI <br /> ENaortar,I cofdfy that'he contacts of Na coratgrunenl miarm io the tams of ine aitaahod EPAAaA riedgmee of CaxIsont <br /> I certify qct the waste minimization stalemort idadlliod ba 40 CFR 26227(a)of i am a 4mpa quanly gectiator)or(b)(rf l am c smalt quantity generator)is true, <br /> Ganarato 00%tora f elffle Typed Nacre Sir rias MoNh Day Yam' <br /> —r Ira.lntema—Wiw- manta <br /> F ❑uaporfd U.B. Evw from U.S. F on a <br /> i 17anspot er elgnnturo((orecgrorts ody): b do team L; - -— <br /> 17-ltanspatarAciawxied{pttentofReca�to'trkdartxa <br /> Tmnsportor i PrinlaZypod Nacre Signal tvionin Day Yu <br /> CO,A' _ r F IS/ <br /> Tr 2PdcWTyped Nano sigrabx Month DO Year <br /> t&Dlsraapanq <br /> iHa.Dik-tapan v hxkWan Sysco y a}Pe ❑NA" ❑Pas Jd P*ct. LJ Fug-,*,Aion i <br /> Manifoat Reforeace Namber. <br /> igb.Al amrk Vvdlty for Generator) U4.EPA ID Nukes , <br /> u PadtAysPhwe: <br /> 1 1Bc Slgnadue of o FWAV rer ior) th Day Yaaz <br /> � 18.tlauardous Waster Report Nanagetrren4 MEtlwd Cabs{I.o.,cedes ftxtrazoudrrua weals Iraatmarct dlaposd,and recydhg systems) <br /> 141 /4t Le <br /> 20.tkatgaated FasiHty Omer or Dperata CeNOcapon of raCaifd of riazardotta materiNa ooverad by dco munlfasi exceq�t ere rated h ibnc 18a <br /> r ntP")ed NamLl <br /> ku a Y <br /> x, <br /> EPA Fomi 67W22(Rev.M6)Prevlaus e0lons are obsoleto. TED FACILITY TO DESTINATION STATE(iF REQUiRED) <br />