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142 <br /> Form Approved.OMB No.2050-0039 <br /> Please print or type. orm a ned for use on elite(12 pitch)typewriter.) 2 Page 1 ofF1=4.one 4.Manifest Tracking Number <br /> UNIFORM HAZARDOUS 1.Generator ID Number (^_99 ryttx 7 t�/[ ti { { r Q� `St"i 6fP::?fft°€4) i.'L1.'`'F4✓ A .�i• cr& <br /> WASTE MANIFEST <br /> mailing address) <br /> 5.Generators Name and Mailing-Address <br /> - Generator's Site Address(if different than <br /> S C '014 STEEL <br /> 3603 E HAMMER LN <br /> I ON s P 9520B <br /> STOCKGenerator's Phone: 2-09-956-4751 U.S.EPA ID Number <br /> 6.Transporter 1 Company Name <br /> SYSTEMS, PC- <br /> U.S.EPA ID Number _ <br /> F8.Desighated <br /> sporter 2 Company Name <br /> q <br /> 4 m �ID Number <br /> Facility Name and Site Address :}f, ••�_ _If{ 5:tl tai :� 4 ?MCI., �`- <br /> 1 72'' C00 PER CRE- ( ROgf E � �)`P, 6irrtr Et�6 fp � } 3 p <br /> 0!"", I P.d-0 =rkT�ti.Ax�r.'I!1 <br /> Facility's Phone: <br /> 10.Containers 11.Total 12.Unit 13.Waste Codes <br /> ya 9b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, a Quantity Wt.N01. <br /> HM and Packing Group(if any)) No. Type <br /> 1. HAZARDOUS WASTE L-2.1-�U rn N-0-9-a- )3- �g�?t�� ���'`�`�- <br /> X €_L.A I INI F1O Tl.�MIM 1 c a3 JYs P-'1�:� 25 _ <br /> o (DTFI-I 0 T <br /> (.4P�t,I(.6, Dt/,30 } f.r'OMA <br /> Z 2• <br /> 0 <br /> 3. <br /> 4. <br /> { <br /> 14.Special Handling Instructions and Additional Information c3Ke_+-,-sP •.P <br /> V. @ 9�fs"Ia.0 2751160 <br /> i)ERC-����7 1 a "� Ifwtt� = ;4u j?��i i . <br /> L4 H E)-1ER0E'��,.Y i t_r-..460-1.7460 �x_AAE 1 <br /> ryPr .,flta,t.-f TI--R >.;," r• �: 4 :t~ tk-R .a <br /> 15. GENERATOR'SIOFFEROR'S CERTIFICATION:I hereby declare that the contents of this consignment are fully and accurately described•above by the proper shipping name,and are classified,packaged, <br /> marked and labeled/placarded,and are in all respects in proper condition for transport according to applicable intemational and national govemmental regulations.If export shipment and I am the Primary <br /> Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. <br /> I certify that the waste minimization statement identified in 40 CFR 262.27(a)(if I am a large quantity generator)or(b)(if I am a small quantity generator)is true. Month Day Year <br /> Signature t; - <br /> Generator's/Offeror's Printedlfyped Name t I <br /> z 16.Intemational'Shipments LJImport to U.S. El /Export from U.S. t Port of entrylexit: <br /> zDate leaving U.S.: <br /> Transporter signature(for exports only): <br /> W 17.TransporterAcknowledgment of Receipt of Materials Month DayUJ <br /> Year <br /> i2 Transporter 1 Printed/iyped Name Signature <br /> O <br /> CL r °f� , - Z All Month Day Year <br /> QTransp er 2 Prihtedffyped Name Signat� <br /> 18.Discrepancy <br /> 18a.Discrepancy Indication Space El Quantity <br /> El Type ❑Residue ❑Partial Rejection ❑Full Rejection <br /> Manifest Reference Number. <br /> U.S.EPA ID Number <br /> 18b.Alternate Facility or Generator) <br /> J <br /> V <br /> iC FacilitysPhone: Month Day Year <br /> W 18c.Signature of Altemate Facility(or Generator) <br /> a <br /> z <br /> 19.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) 4 <br /> a 1. <br /> 12. <br /> 3. <br /> 20.Designated'Facc ility Owner or Operator.Certification of receipt of hazardous materials covered by the manifest except as noted in Item 18a Month Day Year <br /> Phrite,dffyped NameSignage ! r t t - <br /> lit <br /> `° f `" II <br /> DEq-IONATED FACILITY TO GENERATOR <br /> EPA Form 8700=22(Rev.3-05) Previous editio�r ;e obsolete. r' y`" - <br /> .'j•!15 r`15--0Ai 1-35 t� <br />