Laserfiche WebLink
cn N <br /> O O0 -P, <br /> 01 <br /> O N <br /> � � O <br /> N O � <br /> p1 O <br /> in <br /> J CD <br /> M <br /> J <br /> U) D <br /> vT < <br /> CD <br /> ly <br /> %WK <br /> 'TraRSpprlc 2 C�aWmY NM,e <br /> Faolily N--and <br /> .'le 4ed— <br /> O <br /> Facadl+s <br /> 9h.U 5.DO7 L'<_r! ,1��=ue•ng v,eper Sh,pping Name.Nazartl Class,ID Numher, 10.containers tt.Total 12.Unu y, r,A.,y <br /> HM aM Fachirg Grc,c ,a ri, No 7YPe Ouanery w,.Nd. <br /> R <br /> w e•-F <br /> [7 <br /> R� <br /> 2 <br /> 1� 00 <br /> Iq Sp,,A Hardmq 1,,to bens and Add,wnal lnkm,a:on <br /> 9y ' <br /> y y er s7„ppin9 name.a,d are Massdee'P*Xyd <br /> . <br /> rt acwrdin inapplicable inlemational and naWrral gwemmenlal regulaSlms.Nexpenslnpmm'taMVam Na Pixnary <br /> 15NpLSTpRSrDFFERdR'S CERTIFICATION:1 hereby declare Nal the contents of Ibis wn5ignmeM are hAl <br /> and a�uratel desrnhed above 6y Ne p,eP r <br /> rr.,,and labeled llaeaided�and are in fill r Wlcla in Pf,,,the len foo V thepo g nM n..Janf,s we. rear <br /> l Nat Ne conletdsol th�eanaignmani conform rp the terms otlhe attached EPAAcar,wdedgo or Ib1411 amta smalVAua Y 9e luonm DaY �� <br /> p r, eera(Y mini <br /> wa <br /> s�Y dl8t I.he s'as m¢a4pn stasemedt WanMled in 40 GFR 262274a}IN 10.a large quantity <br /> I eiSignature <br /> r ppfyplrarers Pnnledrryped Name <br /> � Port of enVy!exll. _------� . <br /> ❑Expod lmm U.S. <br /> � 15 Ir.;ertmNertal Shpmer,Is ❑Impo+t 1pll5 OaNleavingU.S- <br /> ilure(far experts'211y' Month pay Year <br /> TranspMer 3Qrra <br /> WIT T1l.P"A&lUsledgrr,enl pf Receipt al Materials Signature <br /> Twwn,im I pdrAed/Typsd Name MonR Car reap <br /> QSignature <br /> 0. <br /> w Trarapr"W 2 PrndedRnw Name <br /> a4r� �FUII RejecanM1 <br /> I� ❑padiat Re3actron <br /> t8psdepanrX ar J ❑Residue <br /> f e r uaMd ❑Type <br /> I I&a plsQepar,uy lndolM Spi <br /> Mani1e51 Ref¢rena Numb": �S EpA1D Number <br /> 1RG Ademala FadarY for Genararprl vein <br /> Manlh Dar <br /> J <br /> U <br /> tai Fa�lh/sPh". <br /> W t9:Sr)r!ature MWnWe FwRY for Generakvr <br /> r4 sal,end recyding sYslems} a \ <br /> IN RePad IAanegemenl Method Codes(I.9.,Wde81o,hazardouswacle treatment,dispn. \\ <br /> 15 .Wz4oas 2 ' O <br /> Yea <br /> W t elonth Dau � Q <br /> G pr}Ipzprdpus malanals uuvered by Ne maniSestaxcepf ae noi¢d In Ile„t 1� <br /> x �Fac�lly oww ar Q7er�pr CtldAlCedon drecelpl INITIAL COPY = .. <br /> � GENERATOR'S <br /> .0 <br /> O <br /> EPA Fain 87 22(Rev.3 05)PrevlDus edillvns are Dbsdfele. c3T <br /> N <br /> cc <br /> CD v <br /> 00 <br /> 4 <br /> O <br /> N <br /> O <br />