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W N <br /> SWAST� ;, o o <br /> „yegD�� .r N <br /> m <br /> G� E War <br /> D :v <br /> Form Approved.OM13 No 2650-0039 <br /> cw.v Vrx �.ce pmr a hr� <br /> D I1N,FORMHAZAR000S ErnncRasorna mnm0 C � Ly G , <br /> O <br /> z - NASTE MANIFEST a 31311'-7t36+77�5 <br /> ve mrMp's flame int Vm"Addr v6 t;enarnlni 5 S,Ix Ar -flydMmenl fMn mellkg ad-11 <br /> _ Eiir4ri7J�lgg;l lAPlr�m-nrr�C+P.cam <br /> W LA(nn:p.l A TI <br /> s Pt— r <br /> 6T-Www 1C&M w us EVA Ib Nwnw Ill <br /> .i AOMFCW Chwnaeal TM.0arl 11r-.WA ACTemnn O <br /> y. T.,w*rher7Cwopwry&%- US EPA 10 Number <br /> a OegFybp Feday(Artie And 4dlJrus U 5.EPA IP Number CD <br /> Adrrncad C1„emmW Tr ammv iM11D00p20W71 (�p <br /> 6133Ee namNE Q <br /> 'fib NM a71 a' <br /> �,: Fgyya prprre � � g <br /> 9b US DOT O�ryhMi h cleft ftwShq pin9 Name,Hyard Clens.lG Number 10.Conlarnars }}coral12 11n�1 <br /> h`,V and-+dreg Groote lot anvil Nu t Oeanli7 WI.rvbl 13.Wade Goaes <br /> ype <br /> (D <br /> 1L <br /> 0 <br /> O <br /> `G <br /> O <br /> f�SM-0ifwawynurnlciwrNaraAadaionallnrdrmasdn I ruleyC.M1NrnLwr 1i 9964 OuclYn'ant t ',oC (D <br /> I)E"154, AICT105419(A,4 iVj e"T <br /> P ■rIMW14r�4A �. <br /> dT v <br /> O <br /> GFNERATOR'S'OFFEROR'S CERTMATION:I hereby declare Nal One conatme cl ft consignment are fully and accurately descrihed above by the preper shipping name,are are daSsrh'd,packaged, :3'narlrvi,and labeledplacarddd,and am n ad respects m proper mclihon for hanspon according to applicable intemaGonal and nandnal 9",mrenfal mguiafons_If espart shipment and 1 am the Pnmary <br /> F�poner,I rp by Ar.Tt me mnfenLs of m�E consignment mrrlorm to the terms o11he atlarired EPAAcklrowledgmeMnf Cansanl. n <br /> I en'*M era waste mmirmzanon.staremeni identified in 70 CFR 2112 27{a1 if I am a large quantity generator)or(b}(dl am 3small quantity generator)¢"e <br /> cylw6fferu+sPdniedlTypedName Sigt<IaWre MorriP� pay Year <br /> IE I $rty1MW1 <br /> ❑Import to U c ❑Escort Irom U.S Pon of entryfeml <br /> T:ansparler sgrrakye(M exports only} Dale leaving U.S.tu <br /> , 1 <br /> r'r �otRece+MW Matenais <br /> I <br /> "ra,asporrer 1 pnnlel6'TyTnd Nlarrre <br /> �( 1 Sigrgdture <br /> a <br /> Z TnarGparfer21kaAed,7ypdd Name / y <br /> m Monlh Day Year <br /> le r 11 <br /> 18:T DgctepalryynF,pgry ❑puanhtyi <br /> ❑ ype ❑Residue ❑Parbai Re;echon ❑Full RekKiiDn <br /> 18h Aflerri*Faahfy(nr Geylerelor1 Manifest Reference Number, <br /> U U.S.EPA ID Number ear <br /> d <br /> LL Fadky's P'hyle <br /> LEIw reM <br /> 1$[5if1" Fdlerna4eFafaslylarGenerator? -..- <br /> Z Munih Day YearSpnwl` <br /> 19 ft--Wa*POW frlwragamenl Mehod Cocks 6 e..today Fa hazafduus waste trealmenl,di E <br /> LU <br /> 7 sposal,and recyding syslemsl S <br /> C 2 3 <br /> a <br /> fiesg orad Fady}y GRrrer rNOperalOf LeA+Btatian p1 reboipl of hazard©us maleuals covered by the manifeyl ezoapl as noted in Ilem 18a <br /> Pnrdnd.7yperl Name p CD <br /> Slgnalu o Mcf5lh Day Yew O <br /> v Q <br /> .PA Farm 870422(Rev l2-171 Pre4f0us edlGons are olSsGlele. 3 — <br /> GENERATOR'S INITIAL COPY <br /> . . o <br /> v - <br /> cn <br /> (D - 00 <br /> w <br /> w w <br /> o <br /> 00 <br /> H <br />