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<br /> UNIFORM HAZARDOUSi GRnofatar h]Nnmaer 4,pian€e�TI'I'(dh((a++rtt((Gr��ir((�� /�
<br /> WASTE MANIFEST (i A L 0 0 0:3 EE is( ] tl il, , } , f 1 �1 (7Cklilq O 9 5 L JJ
<br /> 5.Gencrator's Namo slid Mailing Address GeAeralef's situAdthcrss(€f dMotentthan malting address)
<br /> i,,i:';. 1.'i.l.TP()r.:(4 trilAS)-iAND Rr,'PAlR
<br /> Gefl•I<Illui SI PPC1ll!:• i3�;.Zi 111};.1-.(1
<br /> B:Transpo ter'{,1r.pan'I Nalrin U.S.EPA Ip Number
<br /> Grti)(J ; I?: ; 0 t�
<br /> 7 Translx tsr 2 Comr ity Nam* U.S.EPA ID kumtiel
<br /> WORL,I?11 I OF, RECOVERY�Y, li-'ISI INC, C A 1' 0 0();i- 7 tr rS
<br /> 8.Designated Facility Name and Silo draa,' U.S.EPA ID Number
<br /> YLJMA`f-.,"3 1.LC
<br /> (_:1:11"rl 11.1
<br /> 1'Uim,iA A? i.;6 6.13 R 0 0()6 1
<br /> FacJ't's Phoiir:
<br /> Aa. gb.l1.S.DOT Gescnplion(inrAn}ini;P10pnr 5h#gsRGig!•lara2,Ha7atd Nl! $.!(1 blun'Irrt, — .9 o�taino-rs i1,total 12,UN 13.iVas!a Cadbs
<br /> Hl,( eat,d r ati Et Grtlitp li(rtrly'}] -- ___ :t _�FYSN QuElrlily Wl lbnf.
<br /> 1'N0fV,l;(31h 11QARL)OL15 U(fA: i L',,:,(31.11; 1, 4)11.1' ' ,i1.JL3• I'i.i I:: ; . !t.l l_#;'3}
<br /> (� PliU 1
<br /> LU 2.
<br /> %$pada(Handling ins€mclions aild Additional Information
<br /> ,, .�� � .+ r.q i h1 ! � ,_I`(1,LI1':•;r ;1l']-i ', 'sti a -'aIJ(?Fil(SIII'J'f`?
<br /> Ei��1�RiG NCY CONTAOT;G)•If?M'I'V4j:C :( t;C1:)•�( 1 = {) lIV't:;F:'7 I ,<r fit#tV. ;{,',"�'';; .
<br /> O]LY 901M, PAPER FILI'E.R." ^' .!'F+i;t•!'Iilx E. .'l !. I ,J1J#l'Enr.! 7 0.2—• I
<br /> 15: GENERATOR'SIOFFkEROR'5 GERTIFiCAYfON: I hornl,y 1106.61(}Vim t€4n"atnk:tHn 0lhlS r0rlsf9nnVli1 srofil!y tiaa i 1.'I.-ialrly dtts_tibetl ntu;r.by Iijc{Eloper shipping rlamt),old aro 035.010d,Packagtnl,
<br /> lnarkod and+al4JtoWpbcntdr!d,and an,In:til WSpeC19III n UIN a erE1i1'li l+ir IiE1f1 jJIL.i 111 f{h(flffl'b)X41 ILfS117€P•.f4?offuni,ssnr lalsl'•E1$I7I a1 t1t,'rP.i j}e ntilf fgi,iat:nnq.if ej.pri Ski€;njwii and I an,ti'.0 F'rtnnaly
<br /> C Ego ter.t certify rrlat It a ronfunsf r l nils wnaigrvnant coigo(m us nM lwf s m.t ti:e annrlteil GI�AgCE np tlud irlun)n# ;crseu s
<br /> I ee,llfy that the waste r0€nin11200011 statorriun{idontlfted En 443 CFft 2G?..7.s(a1)jd I ntlt a iatg4 quaniity;enamtor).. (pJ(!f i ant a aimil lsar,tlty plerstoi)Is true:
<br /> e 14Nofferor Int !1'y{lad Noris Ig Ria Month Day Year
<br /> '16.International hpa his - > '� _•,._
<br /> Import to U.S.
<br /> transporter sWaluie(totOPo fns rndyJolrlyJ 1::+.4'} Iq U.'S..
<br /> 17,1tanspcularlu kn+rledgmarxall Rereq,r vl Wlerinls
<br /> Eranspa l iriarllr}'poQ 'a,nu __ J $l;nOtufB Month pay Yoar
<br /> Si natUs.� ~+ hi I n Dal Yadr
<br /> Tran �F2 riniaii dam §. P
<br /> 1B.Discrepancy
<br /> 180,Disaepanoy indication Spa❑, ourinlity El 1 ype ❑fte9Wuo ❑Partial Rejec9o11 Ll Full Resection
<br /> Rdunilosi I:GIr,rL�.r,,;Nunjt:ur.
<br /> 18b.Allemflte Facii,ty{❑r GviluraW U.S.CPA ID Nurnpnt
<br /> .:.3
<br /> L)
<br /> I Faaly's Prune:
<br /> U0 180-SignaiureolAlleula[eFacll;tyjar[3encralul) T � mo* Day Year
<br /> 4
<br /> 2
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<br /> 19.hazardous 1Vasta Repoli Management Maihod Canes(i.e., vdes for hurardl!es waste ineaisneni,tfispasal,and rta,yr,'ing sysloms�
<br /> 2. 3 4.
<br /> 20.besignaEc Farjritl 0;Y1jFr y'f7perulnr.{;nrtifir rllirn of rrrp'.0 of 1106.;rmlow. IFh,r vc-
<br /> Pr oiedi yp Ef i'1mmti Si;;nntc,Et! Month Day Year
<br /> ILI 1. I
<br /> FPA Form 8701.22(Rov,3-05) Prgviuus nddionx are ollso€ere. 3`r il, ji4lj'`s; 'i I 4:sf� r 13 L: I �1llflf ii3fV �ilii (i1= FrC f1111('dl::!+)
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