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are—pr{nt or type- Form desi nerl for uee on elite(12-pitch)lypc—l—) Form Approved_OMB No.2050-0039 <br /> UNIFORM"AZAROOUS 1-Ganeratar Ib rvamber 2.Page 1 or 3.Emergency Response Phono. man,test Tracking Number <br /> r-:pD'�925�17 � - <br /> WASTE MANIFEST SKS <br /> 5 6e 'store.Nnmc and Meiriny Aeeranw Generators site Address(if different than malpnq ad—) <br /> ' --- 31d11Fs L'wrs <br /> Generators 1'M1pne ' <br /> R Transpnrlar 1 Company Narna _ 11.5 FPA Ib N,rmha:r <br /> I Transporter 2 Company Nama U S.FPA ID Nrimhr: <br /> 8.Designated Fauliry Name antl Site Address U.S.EPA[p Number <br /> pity's Phone. <br /> qa u. Gai o np on(,nc[uding proper Sh,10119 Name,Nazard Class.1b Nu 1— 10.Gontainars 11.Tmal 12 U.0 t3.Waaler Cods. <br /> HM ubd Pachnrg Gi eu{�f�r4anY)1 Nu. fypa Quantity Wt.Nul. <br /> d <br /> 2. <br /> 3 <br /> 4. <br /> a Specin[Handling Insrn,rJ{nns and ArNiYirural Infnrmalinn �"i try r�M - <br /> 5. tuTOR'SIOFFEROWS CERTIFICATION: 1h—"I--I packagetl, <br /> marked and labe[eetplacareed,dnrt are in an respects I.proper condlil.n for transport according to app[irvhl r.inlerrr:ali«ra{amt rruliunal guvummontal regulations:if expo'!shipment ane[am the P.mary <br /> Exporlar. certify Thal the contents of Ihis c nsignman!wnrurm to Ibe terms of me attached EPAAcknowletlgment of Consent <br /> I certify that Cie waale m4nimlzagun s[ala rt,unl'rduntif url in 4U CFR 2.2-Y7(a)(ir am a[a,ge nuannty generator)or{b)t".am a small q...tiry 9--r)is true. <br /> Genera br'slORar_oryPrinletllTyp.tl Nama Siynalure - Doth Day Year <br /> 1R:[nSsrnaHonaH h,pments u{con a to u s LI Export from U.S. Port of entrylewil: <br /> - sighalure(tar akports onVyJ: <br /> W t7NTI. trotter Re 01 of Mats.ars <br /> ansporeer 1 I=dntparTYpee Name 5lgrraturc M.n1tr bay Year <br /> r 7 <br /> a Transporter 2Prin[etl/Typed N— <br /> ,—.p <br /> ame y tore Y <br /> 6 Month Oe Year <br /> T 1R Discrepancy �4 <br /> a_b,—.p...Y Indir —51— F—I Ouanitly �]Type 0 Resi.us 0 Panfal Reiecllon J-1 Full Ralncrron <br /> Mamfest Reference Number: <br /> b.Alternate Facility lar generator} HS EPA 10 Number <br /> a4i Fatlflly's Phone: <br /> o ttSc.signature or Alternate Faniliry(or Ganara tor) Month Pay Yea <br /> �= 19:Ha'raM.tu w'an'd Repnn Menstnemenr M.:tr,n.i Corir:s(i r-.,rx.rlrrs fa,Aaeardous wash Irealment,tl[sposal,and racycling systems) <br /> 2. 3. <br /> 2U.Desrgna[ed FacillH Owner or Operator.Certification of recelp[of hezartlous materials COyesetl by tM1¢manifest except as nttetl In Item t8a <br /> Pdnt -yped Name gnature Month bay Year <br /> EPA Form 8700-22(Rey.3-05) Prev[ous edlt[ons are obsolete, 6ESI"r4ATED FAr-ILITY TO :,F-IEIIIIII <br /> 301: Overhead Lubrication system drain plug have been tightened to keep them from dripping and <br /> the content has been drained to a Lube cube lubrication containment unit. They will be <br /> monitored during our shop reviews. <br /> 406: All containers in the oil room have been marked or disposed of. <br /> 601, All mentioned waste has been removed and supporting documentation is contained in this <br /> BELOW: <br />