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Please print or type.(Form designed for use on elite 02-pitch)typewriter.) 0 0 6 4 6 1 6 6 8 5 K 8 UNIFORM H ---Ior ID Number Form Approved.OMB No.2050-0039 HAZARDOUS Genera Page I of E rgipricy Response Fill 14.Manifest Track na Me one, I Number WASTE MANIFEST S.Generator's Name and Mailing Address 1006461668 SKS Generators Site Address(if different than mailing address) Generators Phone: 6.lranFpttqr1.Compap,Hamer U.S.EPA ID Number P, 7.Trans-porter 2 Co mili—Name U.S.EPA ID Number s. B.Designated Facility Name and Site Address 1 R U.S.EPA ID Number ff p �'4 Fadd y's Phone: ga, 91 U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 10.Containers HM and Packing Group(if any)) 1 11.Total 12.Unit 13.Waste Codes No. Type I Quantity Wt.Nol. rdn-di 2. —"Tr V-14 r LU 3. 4 14.Special handling Instructions and Additional Information T C af, L)T ,ontentsofthis consignment arefully and accurately described above by the proper shipping name,and are classified,packaged, 15. GENERATOR'$IOFFEROR'S CERTIFICATION: I hereby declare that the r marked and labelediplacarded,and are in all respects in proper condition for transport according to applicable lntematiorial and national governmental regulations.If export shipment and I am the Primary Exporter,I certify that the contents of this consignment conform to the terms of the attached EPAAcknowledgment of Consent. 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. GLnerato roes Printed/Typed Name Signature Month Day— Year XA1 -i [ A-I a9711- -j 16.Interratil pments 01 W- -1 Import to U.S. LJ Export from U.S. Port of ertrylexit: F Transporter signature(for exports only): Date leaving U.S.: — 17,Transporter Acknowledgment of Receipt of Materials LU Transporter I Pri Wteded Name 0 a Signature ear CL ? W Tral r r Z TmVc��5vTrfr i < j I Month D P Signatu 18.Discrepancy 18a.Discrepancy indication Space ❑ Quantity ❑Type ❑Residue ElPartial Rejection ❑Full Rejection 186.Alternate Facility(or Generator) Manifest Reference Number: U.S.EPA ID Number Facility's Phone: 0j u 11 Signature of Alternate Facility(or Generator) Month Day Year 0 F, 19.Hazardous Waste l Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) rp LU 1 — 4-0 2. 3. Designated acill Own or Operator:Certification of receij�of hazardous materials covered by the manifest except a,%ncted in Item 18a 7 Ta — Printed/Typed Name Signat `9 — 4 1 Mo rl Day YW 3-05) Previous editions i — IK Le e111-PCIL EPA Form-8700, -22(Rev. TO .1111N.11111i STATE(IF REQUIRE =—n