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<br /> PIeW pdntortype (F 1?j*ch)typownte'.) Farm .OMB No.2056-0039
<br /> M1 GeneraW ID Number 2.Page 1 33.Emerg�cy one 4,Marataat Tracking NWgberUNIFORM HAZARD ■ i yt41ANIFE3Ttai+�Ql '0--" a00192618
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<br /> &Transporter 1.CaVany Name ! U.S.EPA IU Number
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<br /> r r 1. - nee emm.£!b!(rERQ(t'A 61 VIQATI I hore�!la l W ft ooMonb of Wer gArul ud are and o=waW dwunb d abo ftproper ahl r�eme.and are alamMed, ck ed,
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<br /> me ked and I ledfplacanied,and are In all respeds In pltlpe tondtlonfor trane(lort according to applicable rdamabwdand national govammentd axporl oNpmeni end I am the Pdmery
<br /> Expamr,I ON*that the contend of las canSt nerd omfb Tn to the farina of gra attached EPA Adm iuladgrrarrt of Coneend.
<br /> I'cW4 tta'tttha wast minimtion ataEanard iden0ed in 90 CFR 26227(s)(if I am a large quantity gerlerstot)or(b)(if I owl ly r}i
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<br /> 17.Transporter AcknovAeownt of ReoWdlaterfals
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<br /> 1ea Discrepancylndicabon Space ❑Q.-Ky ❑Type ❑Residue ❑Partial Roectiorl ❑Frdl A*V.
<br /> Mantlest Reference Number:
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<br /> uj t . gn re o mate ad*(err Gienenetor) Momi1 Daly Year
<br /> 18.ftalifts Waste Report ManagsWUM11nod Codes(i.e.,4%(or h rdora watatreatment,dbpoetd,and re systems)
<br /> 20 De ed acllity Owner or icatiar t hazardous ata d by
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<br /> EPAF 22.(Rev, Prertan araob �. A D lYYTO (+tA710N STA {IP.REQUIRED)
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