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07-06-10 11:40am From—D/K CUSTOMER,djLRVICE <br />Pie+aae print or , (Forth desl ned for use on eliter2. Pat®t c <br />UNIFORM HAZARDOUS 1 • Generator ID Nurnba • <br />wASTE LYNIFEST 4 <br />5. GWnretor'a Name ehiafling Address e" JZ"► 1 i ' t } <br />i. Dealipated Faafety Name and Sita Address <br />DEMENNO / KWMN ' <br />p4_ NAWEDA 5TRW <br />CA <br />8b. U.S, DOT Desatpdon (indudhg Proper Shfppin0 Nem, HIM Gaal IQ Numb, <br />Se, <br />HN and Nddng Group (d anY)) <br />t <br />NON RCRA HAZMDOUS <br />+31053783B6 T-460 P.02/02 F-530 <br />Form APProved. OMB No, 205W39 �d <br />9 <br />7 <br />U.S- EPA ID Number <br />' `P 0 6 0 0 1 3 :� 2 <br />Eo'omw Waste Codes <br />00FT <br />®, Special anditne napudiona and on i In eon r <br />1101c I hereby declare mat the contents of this consi@nmantam itdlY and *GcuraP�Y described above DY qra Proper PPbg r en, an! are d I am th <br />5• QEfdEf�T�R' FEROR'e CERTlF�A r condition for transport accordinA epp9ca61edgtemattonaland national Qovernm�ml r�ula�na K export +,hlixt>artt end f ant the Primary <br />marked atld fat>eladlPlacecont end ere a ail t�pecta M grope <br />Exporter I tx►rety Nat the contetda of this consIden a conform to the Parma of t!re attached EPA quantity <br />g gat of Consent tato is we <br />I certify to to wears minim�etlan atatertrent identllfad tr 44 CFR 28227(®) (N I em a terga 4uantlty germ r) a (b) (ltl am a small � � ohm bay <br />or <br />ra Offerors Pd N <br />L <br />/ <br />1 , nternatio hlpmente Pat ofentry ❑ Imporl U 3, - ❑ F ham U.S <br />Date leaving U.S: <br />Transporter a nature (tor exports onw: <br />17. Transporter of of Signature �f Monty DeY <br />Transporter 1 Pd <br />®6Z tont . Day . <br />18. Diaaapancy <br />18a. Discrepancy Indication Specs ❑ ouandty ❑fYPa ❑ Residue <br />M6nitest Reference � <br />lob. Attamale Facility (a Generator) <br />s,s <br />w Fw1ws Phone. <br />Signature of Ai4etnate F a Al <br />n t Method Codes 0,e., codes for heat t, disposal, and recyding systema) <br />19: Maswdoua Waste Report Me agemen 3• <br />Ca <br />of feceipt of hazarous dmatariats covered by the manifest except as noted In item <br />2r1. start Faa"ely a <br />n"!:�'C- <br />EPA <br />C'EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolale- <br />a. <br />F <br />DESIGNATED FACILITY'S COPY <br />