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D1, , — - ;.. I Ir , . , u.r r — — . I ; 1. f I ). , u, I r . I.W 1 .11 <br />RECEIVED At ,I; <br />Foirn ftiuovtY Nfikc4a,� <br />---f,7,�,7 7og NT. no a, <br />UNIFORM HAZAR-060—s <br />JJ K <br />P— <br />WASTE MANIFES <br />f>,wj,u,g 1, Phone, <br />I <br />(,eropt!Iq Home <br />It. u ii f, i -i r; a I A k, <br />9h. 1 8 101 Desaipt[on incffifltq, Proper Shipoinq Na re, Haxrd Claas, 0 Number, <br />12 Ur:t <br />Cvir,s <br />I JIM <br />and Packma G'olji)vyt; <br />O <br />Lli <br />747$—PZ',.-4I —113,am,, <br />15. GEN EPATOR'S!OFFEROR'S CERTIFICATION: i hereby de.lacetr,,a! this wnlents of this consignment are fully and AncvG 67 he prcp-,r ahlppmg Px a' afa C'assifled, pacli, <br />marked and IibeIeiJ1p!1car&d, ardarq In ail !espedq is propel ofidibon for lrnspvfl ncordifiq Ifiappkabio Wemationularid nAtonaj if e),po,t shipment and I am fbp PfIffnary <br />Exposer, i ce ify that the cv,(enf3 Of Mis clnsii,,nment confcml to the forms of the attached EPA AcknoWedgmedA Consent <br />I ceVy !'flat lhe viasle mtnirnizil of) slatemeift jdenl�fjed m 40 CFR UU21(fl) (if I am 3 lvgcs qvwlbly .1101111ftilorl, or b) (iflam a walifj'2W;ry is lititi. <br />Prml, !,Tv;ed V;cnth Days Y,,ef <br />-j <br />If— <br />16 fromU S. Fent1 <br />Impor, to U.S. f Export �fq <br />(fff expudONq). 11k! 4.l AlIrl US, <br />LW <br />17, Trarsoo[W AcI,no0vdqfftw)tof Recemi (if fialorial, <br />Gay <br />Stg�ilure Mll lay <br />LD <br />-2111 —Plv <br />ila, J RkfijeRp r:,:vN, Full e;ectiorl <br />18b 'Olatnale Facility for Gc1cmloO lur b,,, <br />:1 <br />f1how, <br />LU <br />U,�hod rrci'Pn,3 syS:o,os) <br />Mol 1c. <br />