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s k'Yr4 <br /> A� � , 7 h' <br /> I rr r` <br /> ,.d hR"tvf ) ' r See Inshuetianss an back Qf page 6 y, pogo .ar Task <br /> t !f rrplfra�artlrpe�, �F�;r,�on+f,�!►�f2.Phe#�Q,pewr(Nr• r ' ,�, r �.. +e�,n�+�l <br /> r <br /> f +' t 16,GNWapro No M�rl US EPA e�rL1ff' 4r ww No ,` �� Page 9M1fonKalfaL in the'ika ed nasi <br /> �> 'UNIFORM i;iZAR" OUS 'C 'feet r.qulnd�trfvdettal brr <br /> WASTE MANWEST r "� +!- 'fi r �* •+► r cal" ; e'of r <br /> yu r S�'�dY rsel�a�ne d l0-pyngrddress <br /> S Teoneporter 1 Comparry Nano 6 US EPA ID Number <br /> _ 1 r <br /> �� �c�r► xaa lnr3Cjtrie;D ClAlE11191 $1 21 ID3 ri 1 i <br /> 7'Ttgshsporter A Company Naar e U5 EPA ID Number <br />�Z 9 De�Jt'gnrlhd fadpky Nlarpe pnd Site Address It? US EPA ID Number <br />�0 %Y <br /> V ~' FAKI*t Falip Alt-10, CA <1430+ ci Aj t` fl I nj r.1 _41 4 .'161 C4 7 <br />�Z 11 U5 DOT Dererlpfkn(khdludlnp Proper Shlpptnq Name,Hazard Qost,and ID Number) 12 Containers 13 Total 14, UA <br /> No T Quare Wt al <br /> a <br /> 4j_:-s'►!t r L TIN <br /> EFVi 11 yea 9'.17 1L4)Ai i' 'I�r <br /> , J <br /> m N b <br /> E <br /> R <br /> A <br /> r <br /> Q <br /> itz <br /> u, <br /> LU <br /> V <br /> �O <br /> a <br />�4 <br /> Z <br /> O 15 5pec14111 Hendrinq"Inxttons and Additional Infotmafon <br /> z �1 . . r <br /> " 4 <br /> tL �: FfI t r1f11- t I�'ft<n• -� !r 41z- l r^- ^, �` <br /> 16 GENERATOR'S CCQTIf9GTION I hereby declare that the contents of this carman nartl ore folhy and accurately described above by proper thlppinq name and are alatsifredr- <br /> Q packed +narked and lo6elad and are in aA aspens In proper condition for"anrpon by hQhwy oceordny to oWicahle miemahonat and non9nal goVWrnmerir npatailary <br /> ."`.� If I am o large goanhly gonormr,I certify that I have a program in plan to reduce the ,dame and tomedy,of waste panarored to the degree 1 have determined ft be <br /> a ocanornica)ly praefteoble and that I ho-e selected the practicable method of t"ment,rtoroge or dimposal currently available to one which mmimim the piasenr and future <br /> sA threat to human health and the enreonmerar OR 4 1 am a Beall quo"generoror,I have made a good faith effort to minimise my wade gencradart and WW the best <br /> wado rnorro ement method that h avdlable to me and that 1 can afford <br /> O Pnr"d/Typed Name Signature manlb r Dar_ Year <br /> 1 17 Tran offer 1 Acknowfeduament of Recoi i of Aharorlals i <br /> i P (/�rpod Name Signature , - ' F Month Day Year <br /> Uj <br /> f ! t l ► �J•m_ r` C� 1c ` }� � � l� �.r'i_ , 1/•..1+" f- '- [ 4it <br /> g iB lwnr otter 2 Aeknarbd :abort of Raceiat of A+ratierials <br /> LL. 1 Printed/Typed Name Signorure Mantis Day Year <br /> O i <br /> N19 Discrepancy Indiefton Space <br /> a � <br /> u A <br /> Z C <br /> r <br /> E 20 Fac+l CA.mer or Pporovor Cartificat4on of receipt of haxordohn rnaronals oared bv thlr manifest except da noted m Item 19 <br /> T Pant 6ySig �� _ _ CJ� r Qrq <br /> -�=-�—'-- 0 1 <br /> 5 DO NOT WRITE BELOW THIS LINE <br /> D15C 8022A (1195) Groan TRANSPORTER RETAINS <br /> EVA 0700-22 <br />