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c- b W W <br /> CCn CD <br /> O fV O <br /> O O D <br /> O c <br /> O <br /> -68"prrR or 4"ji 0 <br /> IOP nap an el[ta(12-pnchl typawriler N <br /> IT <br /> UNI All NAZAIt us 1 rtBna,ebr iO Numhe, I 2 Papa 1 pf a.Erna as Rao Frnm Apgrpved.OMB No.205o�r1}9 LI•D <br /> atmQJ <br /> MANIFEST CY pnnee PhOnn �,Man11aP1 irBctin�Nur _ _ ��� ` <br /> tors Name a.M GAL 0�` y fAOr.}f�1:1S-g ir]r, Li 'J <br /> FORD— GenOldloY•.�i1e A�{tlexss[�f ninP.enl,hd0 inalking etltlras.st <br /> 7}tACY O t'EAZR WAY `G <br /> GerlePaOo'9 Phone. �.. i AS30� <br /> f Tranappr+er 1 Cprl>pa�y N.n,e FSI <br /> WORLD 01L iEWR.. U 9 EPA,A Number �V <br /> C.AI]a_ <br /> TrergppRarZ4b11►Yny Nang US EPAIDNumber <br /> s MrOAIUWIDE RECi�t:: <br /> tae F.®ay <br /> YES fMAM43EMENT.INC <br /> 61 US FROHI,YAY SS <br /> YUMA <br /> Faouryi Pnorre. AZ S." ' t,7 R U 0 0 5 2 1 14 tom' <br /> 9a Pp.U.S DOT pOSErrpilon liodurlm5 roper Shippin F 9 <br /> HNr and Padnng Group fif anv„ Name.Haaard L1...10 Nam6er. 10.Containers y1 T.,al 12.Unit 19.Wade Codes N <br /> No. Type 0uanliry WtVp,. q <br /> Q., <br /> � O <br /> to <br /> A7 <br /> rn <br /> 3 CD <br /> SCC.\ <br /> 14-Speaal Handil lg instructions and Additional In[ormation O <br /> may► � <br /> EMERGENCY OWACT:CHEMTREC .1-ae0.424-9300 woc:. 'RMINAL r cD <br /> 262623NR2231895 PAPER EATERS ft A APPROPRIATE PPE v"PMEw <br /> 15. GENERATGR'S/OFFEROR'S CERITFICATION,I hereby dediire that the contents of this consignment are fully and acnuataly described above by the proper shipping name.and are dassiBed.packaged. <br /> rnerhed and lobated/placarded,and are in all respects in propercondllion far transport according to applicable international and national governmental regularlons.II export shlpmeni and V am the Primary ��!! <br /> EVoner,i certify that the wriniots of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. C <br /> I certdy that rhe waste mmmizalion stalement identified in 40 CFR 262.2710!llf I am a large quantity generator}or{bl 09 am a small quantity generator)iSlil Y• <br /> Cowafa/s'Olkl PnnieWyped Name Signature Mo,rh Day <br /> Year <br /> J 16Shipments '—I ��$• <br /> LI import In LI-S. ❑Eapo,t from U.S. Port of en4 fexit-, --- <br /> Transporial signature(for exports orly)' Date leaving U.S., CD <br /> >y <br /> W <br /> 17.TransporlerAch oNWgmeni n}Romipl of Materials ¢, <br /> Transppeior 1 PrintedRyped Name �' / Signalure TAanih Day Yeat M <br /> hAunt� Day Maar <br /> 2' TraratWer 2 PrintedlTyped Name Signalure <br /> W <br /> CD <br /> 18.orscaepancy <br /> 18a.OiacrWany indication Space ❑ ❑Residue ❑Partial Reiec6pn ❑Uu keieci <br /> ly n Ouar Type <br /> Manifest Rate'----Number: <br /> U.S.EPA D Number <br /> 18b.Atderrtate Fadlity{or Generalar} ,O <br /> J <br /> (7 <br /> a — Llonth oay Year <br /> LQ 18c.SrgnaEure o!Atternafe FaaTity{or Gereralor) (D <br /> s� O <br /> 19.Hazardlau8 Waste Report Management Method Codes{i,e..codes for hazardous waste treatment disIposal,and fecycliog systems) CD 4 N T ;U <br /> 2 3. <br /> 1 O <br /> O O <br /> or Opwafor.CertilCa6on of receipt of hazardous materiais covered by the maniiesl except as�ided in Item iBa Month 4ay Year <br /> 20. l IsdFa Signalure l <br /> 11 ff I 11 CD � <br /> i 4 L <br /> R ESIGNATED FACILITY TO O,ENERAT01 o <br /> v <br /> ions editions are ovsolet i <br /> (gyp �n,wf` ��5 •u h:' _.... krr rTiL,lVll'itU) -P, <br /> co <br /> O <br /> O <br />