Laserfiche WebLink
~ <br /> ^ -------------��----�r---------��-------------, <br /> �� ����� � � <br /> NON-HAZARDOUS ,,,,`~, ~~ ���,�� �°�, <br /> � <br /> | <br /> ' <br /> � <br /> ` <br /> ; <br /> | <br /> / <br /> ! <br /> ' <br /> ' <br /> � <br /> | <br /> / <br /> | <br /> / <br /> Plea print or type (Form designed for use on a to p )"Writer <br /> INON-AfiiZARDOUS 1.Generator's US EPA M No. manliest 2.page I <br /> Document No. T <br /> _Peloraloes Name and Mallbg Address <br /> 5.Transporter 1 Company Name a. US EPA ID Number A.Stale Transporters ID <br /> 8,Transporter I Phone <br /> 7.TranaWar 2 Company Name 9. US EPA ID Number C.Stale Transporter's to <br /> ID.Transporter 2 Phone <br /> 9.Designated Pomiflity Name and Sille Address 10, US EPA ID Number E.Stale Facility's ID <br /> 11.WASTE DESCRIPT1014 12. Containers 13, 14. <br /> Total urift <br /> No. f Type Quantity Wt./Val. <br /> a. <br /> LU <br /> 0.Additionat DescritAilons for Materials Lishod Above H.Handing Codes for Wastes Usted Above <br /> 15,Spedel Handling Instructions and Additional latormation <br /> / <br /> z <br /> AVANFAVANFAFAWAFAWAVAWAWAWAWAWAWAWM | <br /> in proper conciftlon Our transport The Is 5 re,not siqoct to I tiaz a waste regulations. <br /> Data <br /> T 17.Transporter I AdwDyAodgernent of A"pi of Materials Date <br /> F 19.Discrepancy tndlcsr�Spam <br /> 20.Fid;K—Owner or Operator C W"of reovot of the waafe materials covered by this manifest,except as noted in item I 0 <br /> YJ A-) <br /> { <br /> ' <br />