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Please priM or type.(Form designed hu use on e4te(12-oWh)typewfiter j — s ForM APKNW.OMB No. <br /> UNIFORM HAZAitDQUS i.Generator 1D Number 2.Paged .E 4.1021 racking Number =k <br /> WASTE MANIFEST pZtROcX}2La732. &(Ay9v�fv5dc 008879999 FLE <br /> 5.Generaufs Name and Malliq firC Ked w= <br /> 2098362300 1885 West 11th Street <br /> U.S.CEIVED <br /> EPA ro Nrmsber <br /> Nov 01 <br /> inn .t <br /> T.Transporter 2 Company Name` u.s.EPA ro ft <br /> 21st Qent-Mr-y -E Dmenfa Of Cali, :LAI oo 1 <br /> e.DeNgnaM Facdly Name and Site ,� 1 .U.S.EPAIQ Ntmdrer <br /> 5tericycle, Inc. T T <br /> 2670 Executive Drive °fit- <br /> Indianapolis, IN 46241 i <br /> FawsPhare: 3175245617 INRGG011 0197 <br /> ga. 9b.U.S.DOT (Irdi g Proper Shipping Name,Hazard Crass.ID Number, 10.centabw 11.Total 12.Urdt 13.wasteCO&s <br /> HM <br /> and Paddng Gralp Of any)) ND. Type Qu.'urtdy wtAADL <br /> a X WN2811, Waste Toxic solids, organic, n.o. s. 1 CF 00002 R 311 D007 Deiii <br /> (Chromium, Selenium), 6. 1, PS II, ERG#154 ` <br /> 2-Non RCRR hazardous waste, solid 1 CF 00001 P 311 . <br /> 3. <br /> 4. <br /> s <br /> 14.speft krstrud ffi kft=nar 1.009—MISM Toxic Solids ) 2. 102967(State Regulated Solids) <br /> 1 <br /> = i <br /> 15. GENERATOR'SWFEROR'S CERTWAT1ON:I her*declare eat ere contents of" are fully and amnlely descrtW alwwe by the proper sh#WV rare,and ere dassft.PadMK <br /> marked stmt lebtled1placartlK aM ata in d respects In pry cormlillm for transport accordmg to appka*Wamallonal and national pmrimental replatiorm Hew dripmerd and I am Ute Primary <br /> Exporter,I rely trot the conte of nos coniamr mere tamea of nre allMW EFAAdow"WrIent of ca,sent. <br /> I offhAALl ere is to 40 CFR 262.27(a)(gl am a kMe ly g eneI a aura srnae quantify gerr waW)is true, <br /> G-erabWffe" 'a MO _W1 <br /> Vora_ i <br /> i'r trrterr tiaad r� ❑unprxt a U.S ❑Export trams U.S. Pat d&wexir <br /> Tiansporter s.nature for Dale k U.S.: <br /> W 17.TranspoftAftcMedgmantd . of Mate" <br /> Q" Tren4po Year-., <br /> ��j <br /> mordh �7 6' <br /> 9 i <br /> 18. <br /> 18a.Dlsaepancy Indication Space Q Quantdy ❑Type ❑Residue ❑Partial Refectla. ❑Fun ft*tioo ° <br /> Mardlest Retererice Number. <br /> f eb.Ake mate Fadlky(or U.S.EPA to Number <br /> U <br /> Faclitts Plw t-. <br /> 1& ate <br /> CIM& FacHy(or Generator) Mom Yeti <br /> K w <br /> 19.Hzrardous4laste Report Managenterrt Cad . . as s wade treatment,disposal,WA rerydtrrg systems) '7 <br /> 3. i 4• <br /> Fbcft OwaCr of reI hezardous materials covered by nre as noted kr item 18a 1 <br /> Name <br /> Ile <br /> a& <br /> ty ••••. �__•--••. -�_• - .... ...-.- .....w.....e.•rn e-e nn.ry rn neeewa�arenat Ct1t'PC fIC DFf.11IfR_O <br />